25D2046239 CLIA NUMBER - WARREN YAZOO MENTAL HEALTH SERVICE

Laboratory Demographics

  • CLIA Code: 25D2046239
  • Facility Name: WARREN YAZOO MENTAL HEALTH SERVICE
  • Facility Address: 3442 WISCONSIN AVENUE
    VICKSBURG, MS
    ZIP 39180
  • Facility Phone: 601 634-0181
  • Facility Type: Other - CHEMICAL DEPENDENCY CENTE
  • Facility Type: Waiver
  • Lab Director: DONALD G. BROWN
  • NPI Number: 1710316617
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 25D2046239
LAB Type Other - CHEMICAL DEPENDENCY CENTE
Facility Name WARREN YAZOO MENTAL HEALTH SERVICE
Street 3442 WISCONSIN AVENUE
City VICKSBURG
State MS
ZIP 39180
Phone 601 634-0181
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/29/2024
Certificate Expiration Date 8/28/2026
Facility Type Other - CHEMICAL DEPENDENCY CENTE
Lab Director DONALD G. BROWN

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