25D0897944 CLIA NUMBER - WEST CLINIC WEST CLINIC,THE

Laboratory Demographics

  • CLIA Code: 25D0897944
  • Facility Name: WEST CLINIC WEST CLINIC,THE
  • Facility Address: 7668 AIRWAYS
    SOUTHAVEN, MS
    ZIP 38671
  • Facility Phone: 662 349-4296
  • Facility Type: Physician Office
  • Facility Type: Accreditation
  • Lab Director: ERIC WIEDOWER
  • NPI Number: 1902081557
  • Taxonomy: 2085R0001X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 25D0897944
LAB Type Physician Office
Facility Name WEST CLINIC WEST CLINIC,THE
Street 7668 AIRWAYS
City SOUTHAVEN
State MS
ZIP 38671
Phone 662 349-4296
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 2/11/2024
Certificate Expiration Date 2/10/2026
Facility Type Physician Office
Lab Director ERIC WIEDOWER

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