25D0959212 CLIA NUMBER - MACON MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 25D0959212
  • Facility Name: MACON MEDICAL CLINIC
  • Facility Address: 3878 N JEFFERSON ST
    MACON, MS
    ZIP 39341
  • Facility Phone: 662 726-5831
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. JAMES MEDLIN
  • NPI Number: 1093880874
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 25D0959212
LAB Type Physician Office
Facility Name MACON MEDICAL CLINIC
Street 3878 N JEFFERSON ST
City MACON
State MS
ZIP 39341
Phone 662 726-5831
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/6/2025
Certificate Expiration Date 4/5/2027
Facility Type Physician Office
Lab Director DR. JAMES MEDLIN

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