CLIA lab
CLIA 25D0665647: Coastal Family Health CTR State Line Medical
State Line, MS. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 25D0665647 belongs to Coastal Family Health CTR State Line Medical in State Line, MS.
Certificate for Provider-Performed Microscopy Procedures, effective November 22, 2024, expires November 21, 2026.
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 for Provider-Performed Microscopy Procedures
- Certificate effective
- November 22, 2024
- Certificate expiration
- November 21, 2026
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- September 1, 1992
- Facility type
- Federally qualified health center
- Ownership (control type)
- Government, federal
- 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
- 25D0665647
- Lab name
- Coastal Family Health CTR State Line Medical
- Address
- 256 Main Street, State Line, MS 39362
- Phone
- (601) 394-2381
- Fax
- (601) 394-2593
Annual test volume the lab reported
- Waived tests
- 1,500
- Provider-performed microscopy tests
- 10
- Total
- 1,510
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Related
Questions
What is the CLIA number for Coastal Family Health CTR State Line Medical in State Line?
25D0665647, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Coastal Family Health CTR State Line Medical hold?
A Certificate for Provider-Performed Microscopy Procedures, according to the CMS file.
When does CLIA 25D0665647 expire?
The CMS file lists November 21, 2026 as the certificate expiration date; the certificate took effect November 22, 2024.