25D0911644 CLIA NUMBER - MADISON COUNTY NURSING HOME

Laboratory Demographics

  • CLIA Code: 25D0911644
  • Facility Name: MADISON COUNTY NURSING HOME
  • Facility Address: 1421-A EAST PEACE STREET PO BOX 488
    CANTON, MS
    ZIP 39046
  • Facility Phone: 601 855-5760
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: CAROLYN C. GIBSON
  • NPI Number: 1750431391
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 25D0911644
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name MADISON COUNTY NURSING HOME
Street 1421-A EAST PEACE STREET PO BOX 488
City CANTON
State MS
ZIP 39046
Phone 601 855-5760
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/12/2024
Certificate Expiration Date 2/11/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director CAROLYN C. GIBSON

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