23 Miss. Code. R. 219-1.1 - Provider Enrollment Requirements

Independent laboratory providers must satisfy all requirements set forth in Part 200, Chapter 4, Rule 4.8 in addition to the following provider type specific requirements:

A. National Provider Identifier (NPI), verification from National Plan and Provider Enumeration System (NPPES),
B. Written confirmation from the IRS confirming the tax identification number and legal name, and
C. CLIA certificate and completed Certification form, if applicable.

Notes

23 Miss. Code. R. 219-1.1
Miss. Code Ann. § 43-13-121; 42 CFR 455, Subpart E; Social Security Act § 1902(a)(9)(c)

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