25D2208264 CLIA NUMBER - TLS & ASSOCIATES, LLC

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Laboratory Demographics

CLIA Number: 25D2208264

Facility Name: TLS & ASSOCIATES, LLC

Facility Address:
2135 HENRY HILL DRIVE, STE 200
JACKSON, MS
ZIP 39204
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Facility Phone Number: 601 398-2335

Facility Type: Other - OP PSYCH DAY TREAT

Certificate Type: Waiver

NPI Number: 1073194163

Taxonomy: 261QM1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	25D2208264
LAB Type	Other - OP PSYCH DAY TREAT
Facility Name	TLS & ASSOCIATES, LLC
Street	2135 HENRY HILL DRIVE, STE 200
City	JACKSON
State	MS
ZIP	39204
Phone	601 398-2335
CertificateType	4
CertificateEffectiveDate	1/5/2023
CertificateExpirationDate	1/4/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024