25D0947104 CLIA NUMBER - SUNIL MALHOTRA MD

Laboratory Demographics

  • CLIA Code: 25D0947104
  • Facility Name: SUNIL MALHOTRA MD
  • Facility Address: 470 GOODMAN ROAD
    SOUTHAVEN, MS
    ZIP 38671
  • Facility Phone: 662 536-3330
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. SUNIL MALHOTRA
  • NPI Number: 1841369907
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 25D0947104
LAB Type Physician Office
Facility Name SUNIL MALHOTRA MD
Street 470 GOODMAN ROAD
City SOUTHAVEN
State MS
ZIP 38671
Phone 662 536-3330
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/31/2025
Certificate Expiration Date 7/30/2027
Facility Type Physician Office
Lab Director DR. SUNIL MALHOTRA

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