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HATTIESBURG CLINIC PA NPI 1053493460


NPI Information

NPI: 1053493460
Provider Name: HATTIESBURG CLINIC PA

Doing Business As: CLINICAL LABORATORY

Classification: Clinical Medical Laboratory - 291U00000X
Entity Type: Organization

CLIA Number: 25D0318918

Address:
415 S 28TH AVE
HATTIESBURG, MS
ZIP 39401
Phone: (601) 268-5735
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HATTIESBURG CLINIC PA is a clinical medical laboratory in Hattiesburg, MS. The provider is (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. HATTIESBURG CLINIC PA NPI is 1053493460. The provider is registered as an organization entity type.
The provider Is Doing Business As Clinical Laboratory.

The provider's business location address is:

415 S 28TH AVE
HATTIESBURG, MS
ZIP 39401-246
Phone: (601) 268-5735
Fax: (601) 268-5852

The provider's authorized official is Bryan N Batson .
The authorized official title is Executive Director and has the following contact phone number (601) 268-5601.

The CLIA number assigned to this NPI record is 25D0318918 - ancillary testing site in health care center with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 10/19/2006 and was last updated on 10/7/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1291U00000XClinical Medical LaboratoryYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
100014811MEDICAIDMISSISSIPPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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