25D2017091 CLIA NUMBER - MCCOMB VA PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 25D2017091
  • Facility Name: MCCOMB VA PRIMARY CARE
  • Facility Address: 1308 HARRISON AVENUE
    MCCOMB, MS
    ZIP 39648
  • Facility Phone: 601 250-0965
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: DR. WILLIAM S. HAY
  • NPI Number: 1467762120
  • Taxonomy: 261QV0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 25D2017091
LAB Type Community Clinic
Facility Name MCCOMB VA PRIMARY CARE
Street 1308 HARRISON AVENUE
City MCCOMB
State MS
ZIP 39648
Phone 601 250-0965
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/3/2024
Certificate Expiration Date 12/2/2026
Facility Type Community Clinic
Lab Director DR. WILLIAM S. HAY

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