CLIA lab
CLIA 25D2122171: Grayson Creek Medical Clinic
Moselle, MS. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 25D2122171 belongs to Grayson Creek Medical Clinic in Moselle, MS.
Certificate of Waiver, effective September 10, 2026, expires September 9, 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
- September 10, 2026
- Certificate expiration
- September 9, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- November 21, 2016
- Facility type
- Other practitioner
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
- Directly affiliated labs
- 3
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 25D2122171
- Lab name
- Grayson Creek Medical Clinic
- Address
- 3 John Everett Rd, Moselle, MS 39459
- Phone
- (601) 620-9991
- Fax
- (601) 620-7487
Annual test volume the lab reported
- Waived tests
- 5,000
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Affiliated CLIA numbers
Related
Questions
What is the CLIA number for Grayson Creek Medical Clinic in Moselle?
25D2122171, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Grayson Creek Medical Clinic hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 25D2122171 expire?
The CMS file lists September 9, 2028 as the certificate expiration date; the certificate took effect September 10, 2026.