25D0932806 CLIA NUMBER - MARSHALL COUNTY CORRECTIONAL FACILITY

Laboratory Demographics

CLIA Number: 25D0932806

Facility Name: MARSHALL COUNTY CORRECTIONAL FACILITY

Facility Address:
833 WEST ST
HOLLY SPRINGS, MS
ZIP 38635
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Facility Phone Number: 601 252-7111

Facility Type: Prison

Certificate Type: Waiver

NPI Number: 1588103246

Taxonomy: 363LF0000X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	25D0932806
LAB Type	Prison
Facility Name	MARSHALL COUNTY CORRECTIONAL FACILITY
Street	833 WEST ST
City	HOLLY SPRINGS
State	MS
ZIP	38635
Phone	601 252-7111
CertificateType	4
CertificateEffectiveDate	10/11/2023
CertificateExpirationDate	10/10/2025
FacilityType	Waiver

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