25D0965181 CLIA NUMBER - SENATOBIA FAMILY PRACTICE PC

Laboratory Demographics

  • CLIA Code: 25D0965181
  • Facility Name: SENATOBIA FAMILY PRACTICE PC
  • Facility Address: 104 NORTH ROBINSON STREET
    SENATOBIA, MS
    ZIP 38668
  • Facility Phone: 662 562-0411
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: FORSTER G. RUHL
  • NPI Number: 1932409323
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 25D0965181
LAB Type Physician Office
Facility Name SENATOBIA FAMILY PRACTICE PC
Street 104 NORTH ROBINSON STREET
City SENATOBIA
State MS
ZIP 38668
Phone 662 562-0411
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/14/2025
Certificate Expiration Date 9/13/2027
Facility Type Physician Office
Lab Director FORSTER G. RUHL

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