25D2298218 CLIA NUMBER - JEA SURGICAL, LLC

Laboratory Demographics

  • CLIA Code: 25D2298218
  • Facility Name: JEA SURGICAL, LLC
  • Facility Address: 1026 BAPTIST CIRCLE SUITE 101
    MADISON, MS
    ZIP 39110
  • Facility Phone: 601 353-2020
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: ROBERT A. MALLETTE
  • NPI Number: 1669242822
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 25D2298218
LAB Type Ambulatory Surgery Center
Facility Name JEA SURGICAL, LLC
Street 1026 BAPTIST CIRCLE SUITE 101
City MADISON
State MS
ZIP 39110
Phone 601 353-2020
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/30/2024
Certificate Expiration Date 1/29/2026
Facility Type Ambulatory Surgery Center
Lab Director ROBERT A. MALLETTE

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