25D0873419 CLIA NUMBER - RCG STARKVILLE

Laboratory Demographics

  • CLIA Code: 25D0873419
  • Facility Name: RCG STARKVILLE
  • Facility Address: 111 EUDORA WELTY DR
    STARKVILLE, MS
    ZIP 39759
  • Facility Phone: 662 615-9493
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: THERESA JOHNSON
  • NPI Number: 1295847044
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 25D0873419
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name RCG STARKVILLE
Street 111 EUDORA WELTY DR
City STARKVILLE
State MS
ZIP 39759
Phone 662 615-9493
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/23/2025
Certificate Expiration Date 7/22/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director THERESA JOHNSON

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