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

Laboratory Demographics

  • CLIA Code: 25D1064918
  • Facility Name: MY BROTHER'S KEEPER, INC
  • Facility Address: 805 EAST RIVER PLACE
    JACKSON, MS
    ZIP 39202
  • Facility Phone: 769 216-2455
  • Facility Type: Other - HEALTHCARE CENTER
  • Facility Type: Microscopy
  • Lab Director: LEANDRO MENA
  • NPI Number: 1003582925
  • Taxonomy: 261Q00000X - Clinic/Center

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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
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 12/8/2023
Certificate Expiration Date 12/7/2025
Facility Type Other - HEALTHCARE CENTER
Lab Director LEANDRO MENA

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This page was last updated on: 6/4/2025