25D0969590 CLIA NUMBER - MPC BAY INTERNAL MEDICINE & MULTISPECIALTY

Laboratory Demographics

  • CLIA Code: 25D0969590
  • Facility Name: MPC BAY INTERNAL MEDICINE & MULTISPECIALTY
  • Facility Address: 952 GREEN MEADOW ROAD
    BAY SAINT LOUIS, MS
    ZIP 39520
  • Facility Phone: 228 463-1649
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ASHLEY ROSS
  • NPI Number: 1053369801
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 25D0969590
LAB Type Physician Office
Facility Name MPC BAY INTERNAL MEDICINE & MULTISPECIALTY
Street 952 GREEN MEADOW ROAD
City BAY SAINT LOUIS
State MS
ZIP 39520
Phone 228 463-1649
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/20/2024
Certificate Expiration Date 1/19/2026
Facility Type Physician Office
Lab Director ASHLEY ROSS

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