25D0970111 CLIA NUMBER - LANDMARK INTERNAL MEDICINE

Laboratory Demographics

  • CLIA Code: 25D0970111
  • Facility Name: LANDMARK INTERNAL MEDICINE
  • Facility Address: 7615 CLARINGTON COVE
    SOUTHAVEN, MS
    ZIP 38671
  • Facility Phone: 662 536-2500
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. MUKESH N. JAIN
  • NPI Number: 1215058094
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 25D0970111
LAB Type Physician Office
Facility Name LANDMARK INTERNAL MEDICINE
Street 7615 CLARINGTON COVE
City SOUTHAVEN
State MS
ZIP 38671
Phone 662 536-2500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/1/2024
Certificate Expiration Date 6/30/2026
Facility Type Physician Office
Lab Director DR. MUKESH N. JAIN

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