25D1106353 CLIA NUMBER - MID SOUTH ANESTHESIA CONSULTANTS

Laboratory Demographics

CLIA Number: 25D1106353

Facility Name: MID SOUTH ANESTHESIA CONSULTANTS

Facility Address:
391 SOUTHCREST CIRCLE STE 108
SOUTHAVEN, MS
ZIP 38671
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Facility Phone Number: 662 349-2659

Facility Type: Physician Office

Certificate Type: Accreditation

NPI Number: 1568089993

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	25D1106353
LAB Type	Physician Office
Facility Name	MID SOUTH ANESTHESIA CONSULTANTS
Street	391 SOUTHCREST CIRCLE STE 108
City	SOUTHAVEN
State	MS
ZIP	38671
Phone	662 349-2659
CertificateType	1
CertificateEffectiveDate	11/7/2023
CertificateExpirationDate	11/6/2025
FacilityType	Accreditation

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