25D0965188 CLIA NUMBER - JACKSON ONCOLOGY ASSOCIATES ST DOMINIC CAMPUS

Laboratory Demographics

  • CLIA Code: 25D0965188
  • Facility Name: JACKSON ONCOLOGY ASSOCIATES ST DOMINIC CAMPUS
  • Facility Address: 2969 CURRAN DRIVE NORTH SUITE 200
    JACKSON, MS
    ZIP 39216
  • Facility Phone: 601 974-5525
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: DR. JUSTIN T. BAKER
  • NPI Number: 1346379500
  • Taxonomy: 207RH0003X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 25D0965188
LAB Type Physician Office
Facility Name JACKSON ONCOLOGY ASSOCIATES ST DOMINIC CAMPUS
Street 2969 CURRAN DRIVE NORTH SUITE 200
City JACKSON
State MS
ZIP 39216
Phone 601 974-5525
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 6/1/2024
Certificate Expiration Date 5/31/2026
Facility Type Physician Office
Lab Director DR. JUSTIN T. BAKER

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