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25D0317896 CLIA NUMBER - MISSISSIPPI ASTHMA & ALLERGY CLINIC

Laboratory Demographics

CLIA Number: 25D0317896

Facility Name: MISSISSIPPI ASTHMA & ALLERGY CLINIC

Facility Address:
1513 LAKELAND DRIVE SUITE 101
JACKSON, MS
ZIP 39216
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Facility Phone Number: 601 354-4836

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1548468770

Taxonomy: 207K00000X - Allergy & Immunology
An allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Selected examples of such conditions include asthma, anaphylaxis, rhinitis, eczema, and adverse reactions to drugs, foods, and insect stings as well as immune deficiency diseases (both acquired and congenital), defects in host defense, and problems related to autoimmune disease, organ transplantation, or malignancies of the immune system.

CLIA Record

Field Name Field Value
CLIA Number 25D0317896
LAB Type Physician Office
Facility Name MISSISSIPPI ASTHMA & ALLERGY CLINIC
Street 1513 LAKELAND DRIVE SUITE 101
City JACKSON
State MS
ZIP 39216
Phone 601 354-4836
CertificateType 4
CertificateEffectiveDate 6/1/2022
CertificateExpirationDate 5/31/2024
FacilityType Waiver

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This page was last updated on: 4/23/2024