25D2117895 CLIA NUMBER - TYSON DRUG COMPANY

Laboratory Demographics

  • CLIA Code: 25D2117895
  • Facility Name: TYSON DRUG COMPANY
  • Facility Address: 145 E VAN DORN AVE
    HOLLY SPRINGS, MS
    ZIP 38635
  • Facility Phone: 662 252-2321
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BOB LOMENICK
  • NPI Number: 1760880637
  • Taxonomy: 3336L0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 25D2117895
LAB Type Pharmacy
Facility Name TYSON DRUG COMPANY
Street 145 E VAN DORN AVE
City HOLLY SPRINGS
State MS
ZIP 38635
Phone 662 252-2321
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/25/2024
Certificate Expiration Date 8/24/2026
Facility Type Pharmacy
Lab Director BOB LOMENICK

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