25D2026737 CLIA NUMBER - MAGNOLIA WOMEN'S CENTER

Laboratory Demographics

  • CLIA Code: 25D2026737
  • Facility Name: MAGNOLIA WOMEN'S CENTER
  • Facility Address: 3714 HWY 72 WEST
    CORINTH, MS
    ZIP 38834
  • Facility Phone: 662 293-1575
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. BLAKLEY FOWLER
  • NPI Number: 1639617970
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 25D2026737
LAB Type Physician Office
Facility Name MAGNOLIA WOMEN'S CENTER
Street 3714 HWY 72 WEST
City CORINTH
State MS
ZIP 38834
Phone 662 293-1575
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 7/8/2025
Certificate Expiration Date 7/7/2027
Facility Type Physician Office
Lab Director DR. BLAKLEY FOWLER

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