25D2261840 CLIA NUMBER - WARE FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 25D2261840
  • Facility Name: WARE FAMILY PRACTICE
  • Facility Address: 972 COLUMBIA AVENUE
    PRENTISS, MS
    ZIP 39474
  • Facility Phone: (601) 792-5343
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SHULANDA LAIRD
  • NPI Number: 1730829060
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 25D2261840
LAB Type Physician Office
Facility Name WARE FAMILY PRACTICE
Street 972 COLUMBIA AVENUE
City PRENTISS
State MS
ZIP 39474
Phone 6017925343
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/6/2026
Certificate Expiration Date 6/5/2028
Facility Type Physician Office
Lab Director SHULANDA LAIRD

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This page was last updated on: 5/18/2026