25D2318997 CLIA NUMBER - G A CARMICHAEL FAMILY HEALTH CENTER CANTON WIC

Laboratory Demographics

  • CLIA Code: 25D2318997
  • Facility Name: G A CARMICHAEL FAMILY HEALTH CENTER CANTON WIC
  • Facility Address: 1111 WEST PEACE ST
    CANTON, MS
    ZIP 39046
  • Facility Phone: 601 859-9193
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: JOHN C. FARMER
  • NPI Number: 1871650788
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 25D2318997
LAB Type Federally Qualified Health Center
Facility Name G A CARMICHAEL FAMILY HEALTH CENTER CANTON WIC
Street 1111 WEST PEACE ST
City CANTON
State MS
ZIP 39046
Phone 601 859-9193
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 Federally Qualified Health Center
Lab Director JOHN C. FARMER

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This page was last updated on: 6/4/2025