25D0856603 CLIA NUMBER - MADISON RIDGELAND MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 25D0856603
  • Facility Name: MADISON RIDGELAND MEDICAL CLINIC
  • Facility Address: 11 PROFESSIONAL PARKWAY
    RIDGELAND, MS
    ZIP 39157
  • Facility Phone: 601 856-2460
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: INDIRA VEERISETTY
  • NPI Number: 1316128762
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 25D0856603
LAB Type Physician Office
Facility Name MADISON RIDGELAND MEDICAL CLINIC
Street 11 PROFESSIONAL PARKWAY
City RIDGELAND
State MS
ZIP 39157
Phone 601 856-2460
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 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director INDIRA VEERISETTY

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