25D1068747 CLIA NUMBER - MADISON COUNTY DETENTION CENTER - MEDICAL

Laboratory Demographics

  • CLIA Code: 25D1068747
  • Facility Name: MADISON COUNTY DETENTION CENTER - MEDICAL
  • Facility Address: 2935 HIGHWAY 51 SOUTH
    CANTON, MS
    ZIP 39046
  • Facility Phone: 601 855-0735
  • Facility Type: Other - COUNTY JAIL
  • Facility Type: Waiver
  • Lab Director: PAUL MILLETTE
  • NPI Number: 1518455468
  • Taxonomy: 343900000X - Non-emergency Medical Transport (VAN)

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CLIA Record

Field Name Field Value
CLIA Number 25D1068747
LAB Type Other - COUNTY JAIL
Facility Name MADISON COUNTY DETENTION CENTER - MEDICAL
Street 2935 HIGHWAY 51 SOUTH
City CANTON
State MS
ZIP 39046
Phone 601 855-0735
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/18/2025
Certificate Expiration Date 5/17/2027
Facility Type Other - COUNTY JAIL
Lab Director PAUL MILLETTE

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