25D2259718 CLIA NUMBER - A GOOD MIND TOO

Laboratory Demographics

  • CLIA Code: 25D2259718
  • Facility Name: A GOOD MIND TOO
  • Facility Address: 1012 EAST MAIN ST
    PHILADELPHIA, MS
    ZIP 39350
  • Facility Phone: 601 389-7889
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: ADRIANA L. JENKINS
  • NPI Number: 1841933272
  • Taxonomy: 363LP0808X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 25D2259718
LAB Type Practitioner Other
Facility Name A GOOD MIND TOO
Street 1012 EAST MAIN ST
City PHILADELPHIA
State MS
ZIP 39350
Phone 601 389-7889
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/10/2024
Certificate Expiration Date 5/9/2026
Facility Type Practitioner Other
Lab Director ADRIANA L. JENKINS

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