25D2281523 CLIA NUMBER - MISSISSIPPICARE 126

Laboratory Demographics

  • CLIA Code: 25D2281523
  • Facility Name: MISSISSIPPICARE 126
  • Facility Address: 232 STARLYN AVE
    NEW ALBANY, MS
    ZIP 38652
  • Facility Phone: 662 486-5122
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: KRISTINE PRUITT
  • NPI Number: 1396439899
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 25D2281523
LAB Type Federally Qualified Health Center
Facility Name MISSISSIPPICARE 126
Street 232 STARLYN AVE
City NEW ALBANY
State MS
ZIP 38652
Phone 662 486-5122
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/9/2025
Certificate Expiration Date 5/8/2027
Facility Type Federally Qualified Health Center
Lab Director KRISTINE PRUITT

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