25D2123235 CLIA NUMBER - WADE CLINIC LLC

Laboratory Demographics

  • CLIA Code: 25D2123235
  • Facility Name: WADE CLINIC LLC
  • Facility Address: 206 E TAYLOR AVE
    CALHOUN CITY, MS
    ZIP 38916
  • Facility Phone: 662 628-3838
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: JENNIFER E. WADE
  • NPI Number: 1225580046
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 25D2123235
LAB Type Practitioner Other
Facility Name WADE CLINIC LLC
Street 206 E TAYLOR AVE
City CALHOUN CITY
State MS
ZIP 38916
Phone 662 628-3838
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/15/2024
Certificate Expiration Date 12/14/2026
Facility Type Practitioner Other
Lab Director JENNIFER E. WADE

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