25D0961487 CLIA NUMBER - TYLERTOWN DIALYSIS UNIT

Laboratory Demographics

  • CLIA Code: 25D0961487
  • Facility Name: TYLERTOWN DIALYSIS UNIT
  • Facility Address: TYLERTOWN PLAZA
    TYLERTOWN, MS
    ZIP 39667
  • Facility Phone: 601 296-2960
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: JUSTIN WESTERVELT
  • NPI Number: 1639720717
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 25D0961487
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name TYLERTOWN DIALYSIS UNIT
Street TYLERTOWN PLAZA
City TYLERTOWN
State MS
ZIP 39667
Phone 601 296-2960
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/9/2025
Certificate Expiration Date 6/8/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director JUSTIN WESTERVELT

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