25D2065702 CLIA NUMBER - SOUTH PIKE HIGH CLINIC

Laboratory Demographics

  • CLIA Code: 25D2065702
  • Facility Name: SOUTH PIKE HIGH CLINIC
  • Facility Address: 205 WEST MYRTLE STREET
    MAGNOLIA, MS
    ZIP 39652
  • Facility Phone: 601 783-0420
  • Facility Type: School/Student Health Service
  • Facility Type: Waiver
  • Lab Director: LUCIUS LAMPTON
  • NPI Number: 1265627467
  • Taxonomy: 163WS0200X - Registered Nurse

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CLIA Record

Field Name Field Value
CLIA Number 25D2065702
LAB Type School/Student Health Service
Facility Name SOUTH PIKE HIGH CLINIC
Street 205 WEST MYRTLE STREET
City MAGNOLIA
State MS
ZIP 39652
Phone 601 783-0420
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/12/2025
Certificate Expiration Date 9/11/2027
Facility Type School/Student Health Service
Lab Director LUCIUS LAMPTON

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