25D0950374 CLIA NUMBER - CORINTH SURGICAL CLINIC PA

Laboratory Demographics

CLIA Number: 25D0950374

Facility Name: CORINTH SURGICAL CLINIC PA

Facility Address:
2429 PROPER ST
CORINTH, MS
ZIP 38834
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Facility Phone Number: 601 286-3735

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1891790887

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	25D0950374
LAB Type	Physician Office
Facility Name	CORINTH SURGICAL CLINIC PA
Street	2429 PROPER ST
City	CORINTH
State	MS
ZIP	38834
Phone	601 286-3735
CertificateType	4
CertificateEffectiveDate	4/14/2023
CertificateExpirationDate	4/13/2025
FacilityType	Waiver

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