25D2013400 CLIA NUMBER - MEDICAL IMAGING AT BARNES CROSSING

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Laboratory Demographics

CLIA Number: 25D2013400

Facility Name: MEDICAL IMAGING AT BARNES CROSSING

Facility Address:
891 MISSISSIPPI DRIVE
TUPELO, MS
ZIP 38804
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Facility Phone Number: 662 377-6800

Facility Type: Other - OUTPATIENT RADIOLOGY CLIN

Certificate Type: Waiver

NPI Number: 1316075864

Taxonomy: 2085R0202X - Radiology
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

CLIA Record

Field Name	Field Value
CLIA Number	25D2013400
LAB Type	Other - OUTPATIENT RADIOLOGY CLIN
Facility Name	MEDICAL IMAGING AT BARNES CROSSING
Street	891 MISSISSIPPI DRIVE
City	TUPELO
State	MS
ZIP	38804
Phone	662 377-6800
CertificateType	4
CertificateEffectiveDate	9/20/2022
CertificateExpirationDate	9/19/2024
FacilityType	Waiver

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