CLIA lab
CLIA 25D2191420: Pine Belt Dermatology & Skin Cancer Center
Ellisville, MS. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 25D2191420 belongs to Pine Belt Dermatology & Skin Cancer Center in Ellisville, MS.
Certificate for Provider-Performed Microscopy Procedures, effective September 14, 2025, expires September 13, 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 for Provider-Performed Microscopy Procedures
- Certificate effective
- September 14, 2025
- Certificate expiration
- September 13, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- August 26, 2020
- Facility type
- Physician office
- 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
- 25D2191420
- Lab name
- Pine Belt Dermatology & Skin Cancer Center
- Address
- 1244 Hwy 29 N, Ellisville, MS 39437
- Phone
- (601) 800-9020
- Fax
- (601) 800-9262
Annual test volume the lab reported
- Provider-performed microscopy tests
- 75
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- 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
- Interventional Spine & Sports InstituteCertificate of Waiver, Physician office25D2103440
- 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
Related
Questions
What is the CLIA number for Pine Belt Dermatology & Skin Cancer Center in Ellisville?
25D2191420, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Pine Belt Dermatology & Skin Cancer Center hold?
A Certificate for Provider-Performed Microscopy Procedures, according to the CMS file.
When does CLIA 25D2191420 expire?
The CMS file lists September 13, 2027 as the certificate expiration date; the certificate took effect September 14, 2025.