25D1070510 CLIA NUMBER - RCG - WINONA

Laboratory Demographics

  • CLIA Code: 25D1070510
  • Facility Name: RCG - WINONA
  • Facility Address: 410 HIGHWAY 82
    WINONA, MS
    ZIP 38967
  • Facility Phone: 662 283-6353
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: DR. CANON J. BEISSEL
  • NPI Number: 1225296072
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 25D1070510
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name RCG - WINONA
Street 410 HIGHWAY 82
City WINONA
State MS
ZIP 38967
Phone 662 283-6353
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/29/2023
Certificate Expiration Date 6/28/2025
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director DR. CANON J. BEISSEL

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