25D2318990 CLIA NUMBER - PRIDE MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 25D2318990
  • Facility Name: PRIDE MEDICAL GROUP
  • Facility Address: 456 HIGHWAY 6E
    BATESVILLE, MS
    ZIP 38606
  • Facility Phone: 662 614-7606
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: LEKISHA C. PRIDE
  • NPI Number: 1669299855
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 25D2318990
LAB Type Practitioner Other
Facility Name PRIDE MEDICAL GROUP
Street 456 HIGHWAY 6E
City BATESVILLE
State MS
ZIP 38606
Phone 662 614-7606
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/21/2025
Certificate Expiration Date 2/20/2027
Facility Type Practitioner Other
Lab Director LEKISHA C. PRIDE

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