25D2071185 CLIA NUMBER - RIDGEWOOD CLINICS

Laboratory Demographics

  • CLIA Code: 25D2071185
  • Facility Name: RIDGEWOOD CLINICS
  • Facility Address: 1059 RIDGEWOOD PLACE
    JACKSON, MS
    ZIP 39211
  • Facility Phone: 601 957-3211
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KRISHAN K. GUPTA
  • NPI Number: 1023233749
  • Taxonomy: 101YM0800X - Counselor

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CLIA Record

Field Name Field Value
CLIA Number 25D2071185
LAB Type Physician Office
Facility Name RIDGEWOOD CLINICS
Street 1059 RIDGEWOOD PLACE
City JACKSON
State MS
ZIP 39211
Phone 601 957-3211
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/29/2024
Certificate Expiration Date 7/28/2026
Facility Type Physician Office
Lab Director KRISHAN K. GUPTA

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