25D0317528 CLIA NUMBER - HAZLEHURST CLINIC

Laboratory Demographics

  • CLIA Code: 25D0317528
  • Facility Name: HAZLEHURST CLINIC
  • Facility Address: 213 CALDWELL DRIVE
    HAZLEHURST, MS
    ZIP 39083
  • Facility Phone: 601 894-4661
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: FRED J. MC DONNELL
  • NPI Number: 1356448591
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 25D0317528
LAB Type Physician Office
Facility Name HAZLEHURST CLINIC
Street 213 CALDWELL DRIVE
City HAZLEHURST
State MS
ZIP 39083
Phone 601 894-4661
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 10/25/2024
Certificate Expiration Date 10/24/2026
Facility Type Physician Office
Lab Director FRED J. MC DONNELL

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