25D0672385 CLIA NUMBER - COMMUNITY MEDICAL CENTER LAB

Laboratory Demographics

  • CLIA Code: 25D0672385
  • Facility Name: COMMUNITY MEDICAL CENTER LAB
  • Facility Address: 92 WEST RATLIFF STREET, SUITE A
    LUCEDALE, MS
    ZIP 39452
  • Facility Phone: 601 947-8181
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: LARRY A. HENDERSON
  • NPI Number: 1134558315
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 25D0672385
LAB Type Rural Health Clinic
Facility Name COMMUNITY MEDICAL CENTER LAB
Street 92 WEST RATLIFF STREET, SUITE A
City LUCEDALE
State MS
ZIP 39452
Phone 601 947-8181
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/15/2023
Certificate Expiration Date 11/14/2025
Facility Type Rural Health Clinic
Lab Director LARRY A. HENDERSON

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