25D1107382 CLIA NUMBER - PEARL RIVER FAMILY CLINIC

Laboratory Demographics

  • CLIA Code: 25D1107382
  • Facility Name: PEARL RIVER FAMILY CLINIC
  • Facility Address: 302 HWY 11 S
    POPLARVILLE, MS
    ZIP 39470
  • Facility Phone: 601 403-8284
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. RICHARD CALDERONE
  • NPI Number: 1770715450
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 25D1107382
LAB Type Physician Office
Facility Name PEARL RIVER FAMILY CLINIC
Street 302 HWY 11 S
City POPLARVILLE
State MS
ZIP 39470
Phone 601 403-8284
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/4/2023
Certificate Expiration Date 11/3/2025
Facility Type Physician Office
Lab Director DR. RICHARD CALDERONE

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