25D2284907 CLIA NUMBER - HERNANDO PSYCHIATRY

Laboratory Demographics

  • CLIA Code: 25D2284907
  • Facility Name: HERNANDO PSYCHIATRY
  • Facility Address: 2440 HWY 51 S STE A
    HERNANDO, MS
    ZIP 38632
  • Facility Phone: 662 672-7045
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: ETHAN T. SMITHERMAN
  • NPI Number: 1871831552
  • Taxonomy: 1223G0001X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 25D2284907
LAB Type Practitioner Other
Facility Name HERNANDO PSYCHIATRY
Street 2440 HWY 51 S STE A
City HERNANDO
State MS
ZIP 38632
Phone 662 672-7045
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/29/2025
Certificate Expiration Date 6/28/2027
Facility Type Practitioner Other
Lab Director ETHAN T. SMITHERMAN

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