25D2172152 CLIA NUMBER - PRIME HEALTH AND WELLNESS

Laboratory Demographics

  • CLIA Code: 25D2172152
  • Facility Name: PRIME HEALTH AND WELLNESS
  • Facility Address: 225 COMMUNITY DR STE 101
    FAYETTE, MS
    ZIP 39069
  • Facility Phone: 601 786-8655
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CINDA J. PERRYMAN
  • NPI Number: 1194387217
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 25D2172152
LAB Type Physician Office
Facility Name PRIME HEALTH AND WELLNESS
Street 225 COMMUNITY DR STE 101
City FAYETTE
State MS
ZIP 39069
Phone 601 786-8655
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/17/2025
Certificate Expiration Date 9/16/2027
Facility Type Physician Office
Lab Director CINDA J. PERRYMAN

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