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25D2228229 CLIA NUMBER - NORTH BOLIVAR CONSOLIDATED SCHOOL DISTRICT

Laboratory Demographics

CLIA Number: 25D2228229

Facility Name: NORTH BOLIVAR CONSOLIDATED SCHOOL DISTRICT

Facility Address:
1305 MARTIN LUTHER KING JR BLVD
SHELBY, MS
ZIP 38774
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Facility Phone Number: 662 339-3781

Facility Type: School/Student Health Service

Certificate Type: Waiver
NPI Number: 1063697340

Taxonomy: 313M00000X - Nursing Facility/Intermediate Care Facility
An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals.

CLIA Record

Field Name Field Value
CLIA Number 25D2228229
LAB Type School/Student Health Service
Facility Name NORTH BOLIVAR CONSOLIDATED SCHOOL DISTRICT
Street 1305 MARTIN LUTHER KING JR BLVD
City SHELBY
State MS
ZIP 38774
Phone 662 339-3781
CertificateType 4
CertificateEffectiveDate 6/23/2023
CertificateExpirationDate 6/22/2025
FacilityType Waiver

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