25D2058009 CLIA NUMBER - COMPASS IMAGING LLC

Laboratory Demographics

  • CLIA Code: 25D2058009
  • Facility Name: COMPASS IMAGING LLC
  • Facility Address: 3200 MALLETT ROAD STE E-2
    DIBERVILLE, MS
    ZIP 39540
  • Facility Phone: 228 314-7016
  • Facility Type: Other - OUTPATIENT IMAGING CENTER
  • Facility Type: Waiver
  • Lab Director: MARK WALL
  • NPI Number: 1932453065
  • Taxonomy: 293D00000X - Physiological Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 25D2058009
LAB Type Other - OUTPATIENT IMAGING CENTER
Facility Name COMPASS IMAGING LLC
Street 3200 MALLETT ROAD STE E-2
City DIBERVILLE
State MS
ZIP 39540
Phone 228 314-7016
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/26/2025
Certificate Expiration Date 4/25/2027
Facility Type Other - OUTPATIENT IMAGING CENTER
Lab Director MARK WALL

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