CLIA lab
CLIA 25D2104703: Pecan Park Elementary School-Based
Jackson, MS. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 25D2104703 belongs to Pecan Park Elementary School-Based in Jackson, MS.
Certificate of Waiver, effective October 7, 2026, expires October 6, 2028.
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 7, 2026
- Certificate expiration
- October 6, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- November 10, 2015
- Facility type
- School or student health service
- 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
- 25D2104703
- Lab name
- Pecan Park Elementary School-Based
- Address
- 415 Claiborne Avenue, Jackson, MS 39209
- Phone
- (601) 364-5142
- Fax
- (601) 364-5159
Annual test volume the lab reported
- Waived tests
- 720
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Aaa Jackson Drug and Alcohol Testing LLCCertificate of Waiver, Other practitioner25D2048545
- Abundant Living Community Organizations, IncCertificate of Waiver, Health fair25D2341080
- Aids Healthcare FoundationCertificate of Waiver, Physician office25D2050092
- Alcohol Services CenterCertificate of Waiver, Comprehensive outpatient rehab facility25D2164632
- Alyce G Clarke Center for Medically FragileCertificate of Compliance, Skilled nursing or nursing facility25D2332133
- American Medical Response IncCertificate of Waiver, Ambulance25D0719445
- Associated Pathologists, LLCCertificate of Accreditation, Independent25D2303755
Related
Questions
What is the CLIA number for Pecan Park Elementary School-Based in Jackson?
25D2104703, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Pecan Park Elementary School-Based hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 25D2104703 expire?
The CMS file lists October 6, 2028 as the certificate expiration date; the certificate took effect October 7, 2026.