25D0317348 CLIA NUMBER - RICHARD C RANDOLPH MD PA

Laboratory Demographics

  • CLIA Code: 25D0317348
  • Facility Name: RICHARD C RANDOLPH MD PA
  • Facility Address: 348 CROSSGATES BLVD STE 2200
    BRANDON, MS
    ZIP 39042
  • Facility Phone: 601 825-2466
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. RICHARD C. RANDOLPH
  • NPI Number: 1275632325
  • Taxonomy: 207Q00000X - Family Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 25D0317348
LAB Type Physician Office
Facility Name RICHARD C RANDOLPH MD PA
Street 348 CROSSGATES BLVD STE 2200
City BRANDON
State MS
ZIP 39042
Phone 601 825-2466
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 2/1/2024
Certificate Expiration Date 1/31/2026
Facility Type Physician Office
Lab Director DR. RICHARD C. RANDOLPH

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 9/29/2025