25D1064918 CLIA NUMBER - MY BROTHER'S KEEPER, INC

Laboratory Demographics

CLIA Number: 25D1064918

Facility Name: MY BROTHER'S KEEPER, INC

Facility Address:
805 EAST RIVER PLACE
JACKSON, MS
ZIP 39202
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Facility Phone Number: 769 216-2455

Facility Type: Other - HEALTHCARE CENTER

Certificate Type: Microscopy

NPI Number: 1003582925

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	25D1064918
LAB Type	Other - HEALTHCARE CENTER
Facility Name	MY BROTHER'S KEEPER, INC
Street	805 EAST RIVER PLACE
City	JACKSON
State	MS
ZIP	39202
Phone	769 216-2455
CertificateType	3
CertificateEffectiveDate	12/8/2023
CertificateExpirationDate	12/7/2025
FacilityType	PPMP

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