CLIA lab
CLIA 25D2184690: Blackwell's Family Medicine Clinic
Tylertown, MS. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 25D2184690 belongs to Blackwell's Family Medicine Clinic in Tylertown, MS.
Certificate of Waiver, effective May 22, 2026, expires May 21, 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
- May 22, 2026
- Certificate expiration
- May 21, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- May 22, 2020
- Facility type
- Other practitioner
- Ownership (control type)
- Proprietary
- 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
- 25D2184690
- Lab name
- Blackwell's Family Medicine Clinic
- Address
- 107 Ball Ave, Tylertown, MS 39667
- Phone
- (601) 377-1975
- Fax
- (601) 377-1976
Annual test volume the lab reported
- Waived tests
- 2,500
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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Related
Questions
What is the CLIA number for Blackwell's Family Medicine Clinic in Tylertown?
25D2184690, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Blackwell's Family Medicine Clinic hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 25D2184690 expire?
The CMS file lists May 21, 2028 as the certificate expiration date; the certificate took effect May 22, 2026.