CLIA lab
CLIA 25D2114464: South Delta High School-Based Clinic
Rolling Fork, MS. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 25D2114464 belongs to South Delta High School-Based Clinic in Rolling Fork, MS.
Certificate of Waiver, effective June 14, 2026, expires June 13, 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
- June 14, 2026
- Certificate expiration
- June 13, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- June 14, 2016
- 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
- 25D2114464
- Lab name
- South Delta High School-Based Clinic
- Address
- 138 Weathers Avenue, Rolling Fork, MS 39159
- 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.
Other labs in Rolling Fork, MS
- Delta Health Center - Rolling Fork SatelliteCertificate of Waiver, Federally qualified health center25D2104734
- Fresenius Kidney Care Rolling Fork DialysisCertificate of Waiver, End stage renal disease dialysis facility25D2101531
- Sharkey Issaquena Community HospitalCertificate of Compliance, Hospital25D0317776
- Sharkey Issaquena Complete CareCertificate of Waiver, Physician office25D2268763
- Sharkey Issaquena Medical ClinicCertificate of Waiver, Physician office25D2216213
- Ummc - South Delta High SchoolCertificate of Waiver, School or student health service25D2114460
Related
Questions
What is the CLIA number for South Delta High School-Based Clinic in Rolling Fork?
25D2114464, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does South Delta High School-Based Clinic hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 25D2114464 expire?
The CMS file lists June 13, 2028 as the certificate expiration date; the certificate took effect June 14, 2026.