Organization Active NPI

Smith Lab Testing LLC

  • Clinical Medical Laboratory
  • Tylertown, MS
National Provider Identifier
1386567980
Registry record updated Jul 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
SMITH LAB TESTING LLC
Practice address
33 J C Brister Rd Lot 2
Tylertown, MS 39667-6636
Phone
(601) 551-7623
Fax
(775) 259-8481
NPI assigned
Jul 31, 2026
Last updated
Jul 31, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Deundra Smith
Title
Specimen Collector
Phone
(601) 551-7623

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

33 J C Brister Rd Lot 2
Tylertown, MS 39667-6636

Mailing address

4780 I 55 N Ste 116
Jackson, MS 39211-6067
Phone (601) 551-7623

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1785456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785456000000",
    "number": "1386567980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4780 I 55 N STE 116",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392116067",
            "telephone_number": "601-551-7623",
            "fax_number": "775-259-8481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 J C BRISTER RD LOT 2",
            "city": "TYLERTOWN",
            "state": "MS",
            "postal_code": "396676636",
            "telephone_number": "601-551-7623",
            "fax_number": "775-259-8481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMITH LAB TESTING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-31",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "DEUNDRA",
        "authorized_official_title_or_position": "SPECIMEN COLLECTOR",
        "authorized_official_telephone_number": "601-551-7623",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tylertown, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.