25D1064921 CLIA NUMBER - JACKSON THYROID AND ENDOCRINE CLINIC, PLLC

Laboratory Demographics

  • CLIA Code: 25D1064921
  • Facility Name: JACKSON THYROID AND ENDOCRINE CLINIC, PLLC
  • Facility Address: 971 LAKELAND DRIVE STE 353
    JACKSON, MS
    ZIP 39216
  • Facility Phone: 601 949-6990
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: DR. JOHN W. SISTRUNK
  • NPI Number: 1134671787
  • Taxonomy: 207RE0101X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 25D1064921
LAB Type Physician Office
Facility Name JACKSON THYROID AND ENDOCRINE CLINIC, PLLC
Street 971 LAKELAND DRIVE STE 353
City JACKSON
State MS
ZIP 39216
Phone 601 949-6990
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 8/11/2024
Certificate Expiration Date 8/10/2026
Facility Type Physician Office
Lab Director DR. JOHN W. SISTRUNK

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