25D0718912 CLIA NUMBER - MISSISSIPPI HOMECARE OF JACKSON II LLC DBA MS HOME CARE OF JACKSON

Laboratory Demographics

  • CLIA Code: 25D0718912
  • Facility Name: MISSISSIPPI HOMECARE OF JACKSON II LLC DBA MS HOME CARE OF JACKSON
  • Facility Address: 1200 N STATE ST STE 200
    JACKSON, MS
    ZIP 39202
  • Facility Phone: 601 352-5063
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: JENNIFER KEITH
  • NPI Number: 1053423509
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 25D0718912
LAB Type Home Health Agency
Facility Name MISSISSIPPI HOMECARE OF JACKSON II LLC DBA MS HOME CARE OF JACKSON
Street 1200 N STATE ST STE 200
City JACKSON
State MS
ZIP 39202
Phone 601 352-5063
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Home Health Agency
Lab Director JENNIFER KEITH

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This page was last updated on: 6/4/2025