CLIA lab
CLIA 25D0317604: 121 Medical Place Inc
Mendenhall, MS. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 25D0317604 belongs to 121 Medical Place Inc in Mendenhall, MS.
Certificate of Waiver, effective February 7, 2025, expires February 6, 2027.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- February 7, 2025
- Certificate expiration
- February 6, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- September 1, 1992
- Facility type
- Other practitioner
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 25D0317604
- Lab name
- 121 Medical Place Inc
- Address
- 820 Mangum Dr, Mendenhall, MS 39114
- Phone
- (601) 847-5111
- Fax
- (601) 847-3060
Annual test volume the lab reported
- Waived tests
- 1,300
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Mendenhall, MS
- Alpha & Omega Health ServicesCertificate of Waiver, Physician office25D2339374
- Bedford Care Center of MendenhallCertificate of Waiver, Skilled nursing or nursing facility25D0670169
- Family Health Care Clinic Inc - MendenhallCertificate for Provider-Performed Microscopy Procedures, Federally qualified health center25D0683732
- Mcguffee Drugs, IncCertificate of Waiver, Pharmacy25D2153836
- Mendenhall Medical ClinicCertificate of Waiver, Other practitioner25D2317535
- Mississippi Medical ClinicCertificate of Waiver, Other practitioner25D2258845
- Region 8 Mental HealthCertificate of Waiver, Other25D2097480
- SGH Drive Thru ClinicCertificate of Waiver, Rural health clinic25D2239451
- SGH Medical ClinicCertificate for Provider-Performed Microscopy Procedures, Rural health clinic25D1073931
- Simpson General HospitalCertificate of Compliance, Hospital25D0317612
Related
Questions
What is the CLIA number for 121 Medical Place Inc in Mendenhall?
25D0317604, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does 121 Medical Place Inc hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 25D0317604 expire?
The CMS file lists February 6, 2027 as the certificate expiration date; the certificate took effect February 7, 2025.