25D2318117 CLIA NUMBER - SECOND CHANCE HEALTH & WELLNESS, LLC

Laboratory Demographics

  • CLIA Code: 25D2318117
  • Facility Name: SECOND CHANCE HEALTH & WELLNESS, LLC
  • Facility Address: 11 NORTHTOWN DRIVE, SUITE 225, RM 1
    JACKSON, MS
    ZIP 39211
  • Facility Phone: 601 842-4718
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: DEVIN FOSTER
  • NPI Number: 1861024747
  • Taxonomy: 251K00000X - Public Health or Welfare

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CLIA Record

Field Name Field Value
CLIA Number 25D2318117
LAB Type Community Clinic
Facility Name SECOND CHANCE HEALTH & WELLNESS, LLC
Street 11 NORTHTOWN DRIVE, SUITE 225, RM 1
City JACKSON
State MS
ZIP 39211
Phone 601 842-4718
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/5/2025
Certificate Expiration Date 2/4/2027
Facility Type Community Clinic
Lab Director DEVIN FOSTER

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