CLIA lab

CLIA 25D2326779: Revive Wellness and Aesthetics

Indianola, MS. Certificate and address details from the CMS Provider of Services file for clinical laboratories.

CLIA number 25D2326779 belongs to Revive Wellness and Aesthetics in Indianola, MS.

Certificate of Waiver, effective July 9, 2025, expires July 8, 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 of Waiver
Certificate effective
July 9, 2025
Certificate expiration
July 8, 2027
Status in the CMS file
Active (termination code 00)
Original participation date
July 9, 2025
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
25D2326779
Lab name
Revive Wellness and Aesthetics
Address
110A South Mlk Jr Blvd, Indianola, MS 38751
Phone
(662) 445-2213
Fax
(662) 445-2214

Annual test volume the lab reported

Waived tests
100

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 Revive Wellness and Aesthetics in Indianola?

25D2326779, per the CMS Provider of Services file posted October 16, 2026.

What CLIA certificate does Revive Wellness and Aesthetics hold?

A Certificate of Waiver, according to the CMS file.

When does CLIA 25D2326779 expire?

The CMS file lists July 8, 2027 as the certificate expiration date; the certificate took effect July 9, 2025.

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