25D0919067 CLIA NUMBER - SOUTHAVEN INTERNAL MEDICINE

Laboratory Demographics

  • CLIA Code: 25D0919067
  • Facility Name: SOUTHAVEN INTERNAL MEDICINE
  • Facility Address: 7680 AIRWAYS BLVD
    SOUTHAVEN, MS
    ZIP 38671
  • Facility Phone: (662) 349-1999
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. MAGDI WASSEF
  • NPI Number: 1932259355
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 25D0919067
LAB Type Physician Office
Facility Name SOUTHAVEN INTERNAL MEDICINE
Street 7680 AIRWAYS BLVD
City SOUTHAVEN
State MS
ZIP 38671
Phone 6623491999
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/6/2025
Certificate Expiration Date 8/5/2027
Facility Type Physician Office
Lab Director DR. MAGDI WASSEF

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This page was last updated on: 6/29/2026