25D1103708 CLIA NUMBER - METHODIST SPINE & JOINT CENTER

Laboratory Demographics

CLIA Number: 25D1103708

Facility Name: METHODIST SPINE & JOINT CENTER

Facility Address:
ONE LAYFAIR DRIVE SUITE 100
FLOWOOD, MS
ZIP 39232
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Facility Phone Number: 601 936-8801

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1265527899

Taxonomy: 261QP3300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	25D1103708
LAB Type	Physician Office
Facility Name	METHODIST SPINE & JOINT CENTER
Street	ONE LAYFAIR DRIVE SUITE 100
City	FLOWOOD
State	MS
ZIP	39232
Phone	601 936-8801
CertificateType	4
CertificateEffectiveDate	8/17/2023
CertificateExpirationDate	8/16/2025
FacilityType	Waiver

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