25D2138127 CLIA NUMBER - CALEDONIA COMMUNITY CLINIC

Laboratory Demographics

  • CLIA Code: 25D2138127
  • Facility Name: CALEDONIA COMMUNITY CLINIC
  • Facility Address: 171 SOUTH STREET
    CALEDONIA, MS
    ZIP 39740
  • Facility Phone: 662 251-7389
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: LISA J. HUDSON
  • NPI Number: 1013426329
  • Taxonomy: 363L00000X - Nurse Practitioner

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 25D2138127
LAB Type Community Clinic
Facility Name CALEDONIA COMMUNITY CLINIC
Street 171 SOUTH STREET
City CALEDONIA
State MS
ZIP 39740
Phone 662 251-7389
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/10/2025
Certificate Expiration Date 10/9/2027
Facility Type Community Clinic
Lab Director LISA J. HUDSON

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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