25D1075236 CLIA NUMBER - PICAYUNE FAMILY HEALTH CENTER

Laboratory Demographics

  • CLIA Code: 25D1075236
  • Facility Name: PICAYUNE FAMILY HEALTH CENTER
  • Facility Address: 1911 READ ROAD
    PICAYUNE, MS
    ZIP 39466
  • Facility Phone: 601 251-3500
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Microscopy
  • Lab Director: JAMES W. GRIFFIN
  • NPI Number: 1891150629
  • Taxonomy: 305R00000X - Preferred Provider Organization

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CLIA Record

Field Name Field Value
CLIA Number 25D1075236
LAB Type Federally Qualified Health Center
Facility Name PICAYUNE FAMILY HEALTH CENTER
Street 1911 READ ROAD
City PICAYUNE
State MS
ZIP 39466
Phone 601 251-3500
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 10/16/2025
Certificate Expiration Date 10/15/2027
Facility Type Federally Qualified Health Center
Lab Director JAMES W. GRIFFIN

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