CLIA lab
CLIA 25D2103440: Interventional Spine & Sports Institute
Ellisville, MS. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 25D2103440 belongs to Interventional Spine & Sports Institute in Ellisville, MS.
Certificate of Waiver, effective October 13, 2025, expires October 12, 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
- October 13, 2025
- Certificate expiration
- October 12, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- October 13, 2015
- Facility type
- Physician office
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
- Directly affiliated labs
- 2
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 25D2103440
- Lab name
- Interventional Spine & Sports Institute
- Address
- 92 Hal Crocker Road, Ellisville, MS 39437
- Phone
- (601) 550-3436
- Fax
- (601) 292-6299
Annual test volume the lab reported
- Waived tests
- 1,000
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Affiliated CLIA numbers
Other labs in Ellisville, MS
- Ellisville Family Clinic LaboratoryCertificate of Compliance, Physician office25D0977574
- Ellisville Medical/Obgyn Clinic LabCertificate of Compliance, Other25D0957040
- Ellisville Pediatric ClinicCertificate of Waiver, Rural health clinic25D2070626
- Ellisville State SchoolCertificate of Waiver, Intermediate care facility for individuals with intellectual disabilities25D0030098
- Fast Pace Mississippi, PLLCCertificate of Waiver, Physician office25D2158625
- Jfmc Ellisville LLCCertificate of Waiver, Physician office25D2053253
- Jones County Detention CenterCertificate of Waiver, Prison25D2284642
- Jones County Junior College Health ServicesCertificate of Waiver, School or student health service25D2020826
- Jones County Rest HomeCertificate of Waiver, Skilled nursing or nursing facility25D0651933
- Magnolia Gardens Assisted Living of EllisvilleCertificate of Waiver, Assisted living facility25D2228978
Related
Questions
What is the CLIA number for Interventional Spine & Sports Institute in Ellisville?
25D2103440, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Interventional Spine & Sports Institute hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 25D2103440 expire?
The CMS file lists October 12, 2027 as the certificate expiration date; the certificate took effect October 13, 2025.