25D0651947 CLIA NUMBER - JEFFERSON DAVIS COMMUNITY HOSPITAL

Laboratory Demographics

  • CLIA Code: 25D0651947
  • Facility Name: JEFFERSON DAVIS COMMUNITY HOSPITAL
  • Facility Address: 1102 ROSE STREET
    PRENTISS, MS
    ZIP 39474
  • Facility Phone: 601 792-1168
  • Facility Type: Hospital
  • Facility Type: Certificate of Compliance
  • Lab Director: DR. ANDREW L. DUNN
  • NPI Number: 1649558388
  • Taxonomy: 275N00000X - Medicare Defined Swing Bed Unit

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CLIA Record

Field Name Field Value
CLIA Number 25D0651947
LAB Type Hospital
Facility Name JEFFERSON DAVIS COMMUNITY HOSPITAL
Street 1102 ROSE STREET
City PRENTISS
State MS
ZIP 39474
Phone 601 792-1168
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 1/12/2025
Certificate Expiration Date 1/11/2027
Facility Type Hospital
Lab Director DR. ANDREW L. DUNN

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This page was last updated on: 9/29/2025