25D0710758 CLIA NUMBER - FAMILY MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 25D0710758
  • Facility Name: FAMILY MEDICAL CENTER
  • Facility Address: 1024 MARTIN LUTHER KING DRIVE
    MARKS, MS
    ZIP 38646
  • Facility Phone: 662 326-3502
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: RICHARD E. WALLER
  • NPI Number: 1720585490
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 25D0710758
LAB Type Physician Office
Facility Name FAMILY MEDICAL CENTER
Street 1024 MARTIN LUTHER KING DRIVE
City MARKS
State MS
ZIP 38646
Phone 662 326-3502
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 12/7/2024
Certificate Expiration Date 12/6/2026
Facility Type Physician Office
Lab Director RICHARD E. WALLER

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