25D2130740 CLIA NUMBER - RCG MISSISSIPPI INC DBA NESHOBA COUNTY DIALYSIS

Laboratory Demographics

  • CLIA Code: 25D2130740
  • Facility Name: RCG MISSISSIPPI INC DBA NESHOBA COUNTY DIALYSIS
  • Facility Address: 1100 CENTRAL DR
    PHILADELPHIA, MS
    ZIP 39350
  • Facility Phone: 601 656-2062
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: DR. ROBERT E. CLARK
  • NPI Number: 1710411707
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 25D2130740
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name RCG MISSISSIPPI INC DBA NESHOBA COUNTY DIALYSIS
Street 1100 CENTRAL DR
City PHILADELPHIA
State MS
ZIP 39350
Phone 601 656-2062
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/16/2025
Certificate Expiration Date 5/15/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director DR. ROBERT E. CLARK

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