25D2049743 CLIA NUMBER - ROUTT EYE CLINIC

Laboratory Demographics

  • CLIA Code: 25D2049743
  • Facility Name: ROUTT EYE CLINIC
  • Facility Address: 107 SOUTH NATCHEZ STREET
    KOSCIUSKO, MS
    ZIP 39090
  • Facility Phone: 662 289-4131
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LARRY A. ROUTT
  • NPI Number: 1942487558
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 25D2049743
LAB Type Physician Office
Facility Name ROUTT EYE CLINIC
Street 107 SOUTH NATCHEZ STREET
City KOSCIUSKO
State MS
ZIP 39090
Phone 662 289-4131
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/13/2024
Certificate Expiration Date 11/12/2026
Facility Type Physician Office
Lab Director LARRY A. ROUTT

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