25D2185754 CLIA NUMBER - CCH CLINIC TAYLORSVILLE

Laboratory Demographics

  • CLIA Code: 25D2185754
  • Facility Name: CCH CLINIC TAYLORSVILLE
  • Facility Address: 105 EATON ST
    TAYLORSVILLE, MS
    ZIP 39168
  • Facility Phone: 601 452-4280
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: DR. THOMAS BLACKLEDGE
  • NPI Number: 1306460282
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 25D2185754
LAB Type Rural Health Clinic
Facility Name CCH CLINIC TAYLORSVILLE
Street 105 EATON ST
City TAYLORSVILLE
State MS
ZIP 39168
Phone 601 452-4280
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/9/2024
Certificate Expiration Date 6/8/2026
Facility Type Rural Health Clinic
Lab Director DR. THOMAS BLACKLEDGE

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