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25D1039754 CLIA NUMBER - MISSISSIPPI METHODIST REHABILITATION CENTER

Laboratory Demographics

CLIA Number: 25D1039754

Facility Name: MISSISSIPPI METHODIST REHABILITATION CENTER

Facility Address:
1350 E WOODROW WILSON DR
JACKSON, MS
ZIP 39216
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Facility Phone Number: 601 981-2611

Facility Type: Hospital

Certificate Type: Waiver
NPI Number: 1770621963

Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

CLIA Record

Field Name Field Value
CLIA Number 25D1039754
LAB Type Hospital
Facility Name MISSISSIPPI METHODIST REHABILITATION CENTER
Street 1350 E WOODROW WILSON DR
City JACKSON
State MS
ZIP 39216
Phone 601 981-2611
CertificateType 4
CertificateEffectiveDate 4/21/2023
CertificateExpirationDate 4/20/2025
FacilityType Waiver

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