25D2241543 CLIA NUMBER - DESOTO COUNTY ADULT DETENTION FACILITY

Laboratory Demographics

  • CLIA Code: 25D2241543
  • Facility Name: DESOTO COUNTY ADULT DETENTION FACILITY
  • Facility Address: 3425 INDUSTRIAL DR W
    HERNANDO, MS
    ZIP 38632
  • Facility Phone: 662 469-8551
  • Facility Type: Prison
  • Facility Type: Waiver
  • Lab Director: CHAD M. WICKER
  • NPI Number: 1043427198
  • Taxonomy: 163WS0200X - Registered Nurse

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CLIA Record

Field Name Field Value
CLIA Number 25D2241543
LAB Type Prison
Facility Name DESOTO COUNTY ADULT DETENTION FACILITY
Street 3425 INDUSTRIAL DR W
City HERNANDO
State MS
ZIP 38632
Phone 662 469-8551
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/29/2023
Certificate Expiration Date 10/28/2025
Facility Type Prison
Lab Director CHAD M. WICKER

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