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25D2050092 CLIA NUMBER - AIDS HEALTHCARE FOUNDATION

Laboratory Demographics

CLIA Number: 25D2050092

Facility Name: AIDS HEALTHCARE FOUNDATION

Facility Address:
766 LAKELAND DR STE A
JACKSON, MS
ZIP 39216
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Facility Phone Number: 601 368-3440

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1548772593

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name Field Value
CLIA Number 25D2050092
LAB Type Physician Office
Facility Name AIDS HEALTHCARE FOUNDATION
Street 766 LAKELAND DR STE A
City JACKSON
State MS
ZIP 39216
Phone 601 368-3440
CertificateType 4
CertificateEffectiveDate 11/20/2022
CertificateExpirationDate 11/19/2024
FacilityType Waiver

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This page was last updated on: 4/23/2024