25D2053253 CLIA NUMBER - JFMC ELLISVILLE LLC

Laboratory Demographics

  • CLIA Code: 25D2053253
  • Facility Name: JFMC ELLISVILLE LLC
  • Facility Address: 85 HAL CROCKER RD
    ELLISVILLE, MS
    ZIP 39437
  • Facility Phone: 601 719-0092
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. MATTHEW B. JONES
  • NPI Number: 1407121338
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 25D2053253
LAB Type Physician Office
Facility Name JFMC ELLISVILLE LLC
Street 85 HAL CROCKER RD
City ELLISVILLE
State MS
ZIP 39437
Phone 601 719-0092
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/27/2024
Certificate Expiration Date 7/26/2026
Facility Type Physician Office
Lab Director DR. MATTHEW B. JONES

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