25D0959912 CLIA NUMBER - WESLEY PHYSICIAN SERVICES LLC

Laboratory Demographics

CLIA Number: 25D0959912

Facility Name: WESLEY PHYSICIAN SERVICES LLC

Facility Address:
39 FRANKLIN RD STE 220
HATTIESBURG, MS
ZIP 39402
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Facility Phone Number: 601 296-3050

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1538200209

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	25D0959912
LAB Type	Physician Office
Facility Name	WESLEY PHYSICIAN SERVICES LLC
Street	39 FRANKLIN RD STE 220
City	HATTIESBURG
State	MS
ZIP	39402
Phone	601 296-3050
CertificateType	4
CertificateEffectiveDate	2/15/2024
CertificateExpirationDate	2/14/2026
FacilityType	Waiver

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