25D2256609 CLIA NUMBER - HINDS BEHAVIORAL INTEGRATED CARE

Laboratory Demographics

  • CLIA Code: 25D2256609
  • Facility Name: HINDS BEHAVIORAL INTEGRATED CARE
  • Facility Address: 3450 HWY 80W STE 71
    JACKSON, MS
    ZIP 39209
  • Facility Phone: 769 237-4581
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: DR. LIONEL FRASER
  • NPI Number: 1497156384
  • Taxonomy: 101YM0800X - Counselor

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CLIA Record

Field Name Field Value
CLIA Number 25D2256609
LAB Type Federally Qualified Health Center
Facility Name HINDS BEHAVIORAL INTEGRATED CARE
Street 3450 HWY 80W STE 71
City JACKSON
State MS
ZIP 39209
Phone 769 237-4581
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/25/2024
Certificate Expiration Date 3/24/2026
Facility Type Federally Qualified Health Center
Lab Director DR. LIONEL FRASER

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