25D2049350 CLIA NUMBER - HIGHLAND PEDIATRIC & PRIMARY CARE RURAL HEALTH CLI

Laboratory Demographics

  • CLIA Code: 25D2049350
  • Facility Name: HIGHLAND PEDIATRIC & PRIMARY CARE RURAL HEALTH CLI
  • Facility Address: 146 HIGHLAND PKWY
    PICAYUNE, MS
    ZIP 39466
  • Facility Phone: 601 358-9765
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. WALTER E. GIPSON IV
  • NPI Number: 1922574425
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 25D2049350
LAB Type Physician Office
Facility Name HIGHLAND PEDIATRIC & PRIMARY CARE RURAL HEALTH CLI
Street 146 HIGHLAND PKWY
City PICAYUNE
State MS
ZIP 39466
Phone 601 358-9765
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/22/2024
Certificate Expiration Date 3/21/2026
Facility Type Physician Office
Lab Director DR. WALTER E. GIPSON IV

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