25D2275834 CLIA NUMBER - SKY INTEGRATIVE MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 25D2275834
  • Facility Name: SKY INTEGRATIVE MEDICAL CENTER
  • Facility Address: 408 FONTAINE PL STE 104
    RIDGELAND, MS
    ZIP 39157
  • Facility Phone: 601 617-7177
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ALISHA MCARTHUR WILKES
  • NPI Number: 1235845892
  • Taxonomy: 261QH0100X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 25D2275834
LAB Type Physician Office
Facility Name SKY INTEGRATIVE MEDICAL CENTER
Street 408 FONTAINE PL STE 104
City RIDGELAND
State MS
ZIP 39157
Phone 601 617-7177
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/30/2025
Certificate Expiration Date 1/29/2027
Facility Type Physician Office
Lab Director ALISHA MCARTHUR WILKES

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