25D1091410 CLIA NUMBER - MAGNOLIA PEDIATRIC CLINIC

Laboratory Demographics

CLIA Number: 25D1091410

Facility Name: MAGNOLIA PEDIATRIC CLINIC

Facility Address:
401 ALCORN DRIVE, STE 1B
CORINTH, MS
ZIP 38834
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Facility Phone Number: 662 293-7390

Facility Type: Physician Office

Certificate Type: Certificate of Compliance

NPI Number: 1104078328

Taxonomy: 208000000X - Pediatrics
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

CLIA Record

Field Name	Field Value
CLIA Number	25D1091410
LAB Type	Physician Office
Facility Name	MAGNOLIA PEDIATRIC CLINIC
Street	401 ALCORN DRIVE, STE 1B
City	CORINTH
State	MS
ZIP	38834
Phone	662 293-7390
CertificateType	2
CertificateEffectiveDate	10/26/2023
CertificateExpirationDate	10/25/2025
FacilityType	Compliance

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This page was last updated on: 4/23/2024