25D0317474 CLIA NUMBER - CRYSTAL SPRINGS CLINIC

Laboratory Demographics

  • CLIA Code: 25D0317474
  • Facility Name: CRYSTAL SPRINGS CLINIC
  • Facility Address: 123 BOBO DRIVE
    CRYSTAL SPRINGS, MS
    ZIP 39059
  • Facility Phone: 601 892-2225
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: KEN WHITTINGTON
  • NPI Number: 1972603819
  • Taxonomy: 261QR1300X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 25D0317474
LAB Type Physician Office
Facility Name CRYSTAL SPRINGS CLINIC
Street 123 BOBO DRIVE
City CRYSTAL SPRINGS
State MS
ZIP 39059
Phone 601 892-2225
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 10/29/2024
Certificate Expiration Date 10/28/2026
Facility Type Physician Office
Lab Director KEN WHITTINGTON

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