25D1101359 CLIA NUMBER - LAKEISHA RICHARDSON MD

Laboratory Demographics

  • CLIA Code: 25D1101359
  • Facility Name: LAKEISHA RICHARDSON MD
  • Facility Address: 302 ARNOLD AVENUE
    GREENVILLE, MS
    ZIP 38701
  • Facility Phone: 662 335-2093
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: LAKEISHA RICHARDSON
  • NPI Number: 1417132689
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 25D1101359
LAB Type Practitioner Other
Facility Name LAKEISHA RICHARDSON MD
Street 302 ARNOLD AVENUE
City GREENVILLE
State MS
ZIP 38701
Phone 662 335-2093
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/14/2024
Certificate Expiration Date 12/13/2026
Facility Type Practitioner Other
Lab Director LAKEISHA RICHARDSON

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