25D0919850 CLIA NUMBER - STATE VETERANS AFFAIRS BOARD

Laboratory Demographics

  • CLIA Code: 25D0919850
  • Facility Name: STATE VETERANS AFFAIRS BOARD
  • Facility Address: 120 NORTH ST
    JACKSON, MS
    ZIP 39201
  • Facility Phone: 601 576-4857
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: MARK SMITH
  • NPI Number: 1982811642
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 25D0919850
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name STATE VETERANS AFFAIRS BOARD
Street 120 NORTH ST
City JACKSON
State MS
ZIP 39201
Phone 601 576-4857
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/18/2024
Certificate Expiration Date 9/17/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director MARK SMITH

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