CLIA lab
CLIA 25D2063415: Delta Primary Care Rural Health Clinic
Indianola, MS. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 25D2063415 belongs to Delta Primary Care Rural Health Clinic in Indianola, MS.
Certificate of Waiver, effective August 1, 2025, expires July 31, 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
- August 1, 2025
- Certificate expiration
- July 31, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- August 1, 2013
- Facility type
- Rural health clinic
- 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
- 25D2063415
- Lab name
- Delta Primary Care Rural Health Clinic
- Address
- 110 Baker Street, Indianola, MS 38751
- Phone
- (601) 594-7079
- Fax
- (866) 717-6958
Annual test volume the lab reported
- Waived tests
- 2,000
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Indianola, MS
- Delta Health CTR Indianola Family & ChildrenCertificate of Waiver, Rural health clinic25D2080145
- Delta Health Center Carver ElementaryCertificate of Waiver, Federally qualified health center25D2171528
- Delta Health Center Lockard Elementary SchoolCertificate of Waiver, School or student health service25D2171526
- Home Health Care Services Inc DBA Adoration HomeCertificate of Waiver, Home health agency25D0899749
- Indianola Family Medical GroupCertificate of Accreditation, Physician office25D0316807
- Indianola Rehabilitation and Healthcare CenterCertificate of Waiver, Skilled nursing or nursing facility25D0674986
- Magic Mart PharmacyCertificate of Waiver, Pharmacy25D2194086
- Platinum Plus Care LLCCertificate of Waiver, Assisted living facility25D2193926
- Quality Family Care, LLCCertificate of Waiver, Other practitioner25D2138007
- RCG Mississippi IncCertificate of Waiver, End stage renal disease dialysis facility25D0885969
Related
Questions
What is the CLIA number for Delta Primary Care Rural Health Clinic in Indianola?
25D2063415, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Delta Primary Care Rural Health Clinic hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 25D2063415 expire?
The CMS file lists July 31, 2027 as the certificate expiration date; the certificate took effect August 1, 2025.