25D1103124 CLIA NUMBER - AIR EVAC EMS #87

Laboratory Demographics

  • CLIA Code: 25D1103124
  • Facility Name: AIR EVAC EMS #87
  • Facility Address: 1609 HOSPITAL STREET
    GREENVILLE, MS
    ZIP 38703
  • Facility Phone: 601 218-7631
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: LEE JOHNNY WILLIAMS
  • NPI Number: 1124257670
  • Taxonomy: 3416A0800X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 25D1103124
LAB Type Ambulance
Facility Name AIR EVAC EMS #87
Street 1609 HOSPITAL STREET
City GREENVILLE
State MS
ZIP 38703
Phone 601 218-7631
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/3/2025
Certificate Expiration Date 8/2/2027
Facility Type Ambulance
Lab Director LEE JOHNNY WILLIAMS

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