25D0980065 CLIA NUMBER - SOUTHEAST UROLOGY NETWORK

Laboratory Demographics

  • CLIA Code: 25D0980065
  • Facility Name: SOUTHEAST UROLOGY NETWORK
  • Facility Address: 7420 GUTHRIE DRIVE NORTH, SUITE 111
    SOUTHAVEN, MS
    ZIP 38671
  • Facility Phone: 901 527-7100
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARK J. SASLAWSKY
  • NPI Number: 1184770356
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 25D0980065
LAB Type Physician Office
Facility Name SOUTHEAST UROLOGY NETWORK
Street 7420 GUTHRIE DRIVE NORTH, SUITE 111
City SOUTHAVEN
State MS
ZIP 38671
Phone 901 527-7100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/9/2024
Certificate Expiration Date 11/8/2026
Facility Type Physician Office
Lab Director MARK J. SASLAWSKY

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This page was last updated on: 6/4/2025