14D1025083 CLIA NUMBER - PANOLA WOMEN'S AND CHILDREN'S CLINIC

Laboratory Demographics

CLIA Number: 14D1025083

Facility Name: PANOLA WOMEN'S AND CHILDREN'S CLINIC

Facility Address:
255 MEDICAL CENTER DRIVE
BATESVILLE, MS
ZIP 38606
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Facility Phone Number: 662 563-2163

Facility Type: Rural Health Clinic

Certificate Type: Microscopy

NPI Number: 1700349222

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	14D1025083
LAB Type	Rural Health Clinic
Facility Name	PANOLA WOMEN'S AND CHILDREN'S CLINIC
Street	255 MEDICAL CENTER DRIVE
City	BATESVILLE
State	MS
ZIP	38606
Phone	662 563-2163
CertificateType	3
CertificateEffectiveDate	4/28/2024
CertificateExpirationDate	4/27/2026
FacilityType	PPMP

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This page was last updated on: 4/23/2024