CLIA lab
CLIA 25D0965187: Johnson Elementary School-Based Clinic
Jackson, MS. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 25D0965187 belongs to Johnson Elementary School-Based Clinic in Jackson, MS.
Certificate of Waiver, effective September 14, 2025, expires September 13, 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
- September 14, 2025
- Certificate expiration
- September 13, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- September 14, 1999
- Facility type
- Federally qualified health center
- Ownership (control type)
- Other
- 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
- 25D0965187
- Lab name
- Johnson Elementary School-Based Clinic
- Address
- 1339 Oak Park Drive, Jackson, MS 39213
- Phone
- (601) 362-5321
- Fax
- (601) 364-5159
Annual test volume the lab reported
- Waived tests
- 500
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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Related
Questions
What is the CLIA number for Johnson Elementary School-Based Clinic in Jackson?
25D0965187, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Johnson Elementary School-Based Clinic hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 25D0965187 expire?
The CMS file lists September 13, 2027 as the certificate expiration date; the certificate took effect September 14, 2025.