25D2129722 CLIA NUMBER - KIDS' KASTLE LLC

Laboratory Demographics

  • CLIA Code: 25D2129722
  • Facility Name: KIDS' KASTLE LLC
  • Facility Address: 2359 OAKHURST DRIVE
    JACKSON, MS
    ZIP 39204
  • Facility Phone: 601 622-4677
  • Facility Type: Other - PRESCR PED EXT CARE
  • Facility Type: Waiver
  • Lab Director: VERLENCIA MYERS
  • NPI Number: 1073390399
  • Taxonomy: 261QM3000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 25D2129722
LAB Type Other - PRESCR PED EXT CARE
Facility Name KIDS' KASTLE LLC
Street 2359 OAKHURST DRIVE
City JACKSON
State MS
ZIP 39204
Phone 601 622-4677
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/25/2025
Certificate Expiration Date 4/24/2027
Facility Type Other - PRESCR PED EXT CARE
Lab Director VERLENCIA MYERS

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