Clinical Laboratory Information
Similar CLIA Codes
|
|
CLIA Number
|
25D2322213
|
|
Clinical laboratory number
|
|
Lab Name
|
MAGNOLIA FAMILY WELLNESS CLINIC
|
|
Laboratory Name
|
|
Lab Type
|
Practitioner Other
|
|
Laboratory Type
|
|
Certificate Type
|
PPMP
|
|
Clinical laboratory certificate type
|
Contacts |
|
Phone
|
601-466-2056
|
|
Laboratory telephone number
|
|
Fax
|
N/S (NOT SPECIFIED)
|
|
Fax number of the provider.
|
Facility Location |
|
Street Address
|
5056 W 4TH STREET #100
|
|
Primary location adress line
|
|
City
|
HATTIESBURG
|
|
Primary location city name
|
|
State
|
MS
|
|
Primary location state name
|
|
Zip
|
39402
|
|
Primary location postal code
|