25D2029494 CLIA NUMBER - MEA MEDICAL CLINIC VICKSBURG

Laboratory Demographics

  • CLIA Code: 25D2029494
  • Facility Name: MEA MEDICAL CLINIC VICKSBURG
  • Facility Address: 4204 CLAY ST
    VICKSBURG, MS
    ZIP 39183
  • Facility Phone: 601 619-7717
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: KIRBY ORME
  • NPI Number: 1649755208
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 25D2029494
LAB Type Physician Office
Facility Name MEA MEDICAL CLINIC VICKSBURG
Street 4204 CLAY ST
City VICKSBURG
State MS
ZIP 39183
Phone 601 619-7717
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 1/19/2024
Certificate Expiration Date 1/18/2026
Facility Type Physician Office
Lab Director KIRBY ORME

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