25D1005167 CLIA NUMBER - MAGNOLIA ENDOSCOPY CENTER LLC

Laboratory Demographics

  • CLIA Code: 25D1005167
  • Facility Name: MAGNOLIA ENDOSCOPY CENTER LLC
  • Facility Address: 3050 CORDER DRIVE
    CORINTH, MS
    ZIP 38834
  • Facility Phone: 662 284-9902
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: FRED A. CORDER
  • NPI Number: 1740264274
  • Taxonomy: 261QE0800X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 25D1005167
LAB Type Ambulatory Surgery Center
Facility Name MAGNOLIA ENDOSCOPY CENTER LLC
Street 3050 CORDER DRIVE
City CORINTH
State MS
ZIP 38834
Phone 662 284-9902
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/16/2024
Certificate Expiration Date 10/15/2026
Facility Type Ambulatory Surgery Center
Lab Director FRED A. CORDER

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