25D0902620 CLIA NUMBER - HATTIESBURG FAMILY HEALTH CENTER

Laboratory Demographics

CLIA Number: 25D0902620

Facility Name: HATTIESBURG FAMILY HEALTH CENTER

Facility Address:
66 OLD AIRPORT ROAD
HATTIESBURG, MS
ZIP 39401
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Facility Phone Number: 601 545-8700

Facility Type: Community Clinic

Certificate Type: Microscopy

NPI Number: 1538136940

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	25D0902620
LAB Type	Community Clinic
Facility Name	HATTIESBURG FAMILY HEALTH CENTER
Street	66 OLD AIRPORT ROAD
City	HATTIESBURG
State	MS
ZIP	39401
Phone	601 545-8700
CertificateType	3
CertificateEffectiveDate	2/13/2023
CertificateExpirationDate	2/12/2025
FacilityType	PPMP

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This page was last updated on: 4/23/2024