25D2068071 CLIA NUMBER - HICKORY FLAT CLINIC LLC

Laboratory Demographics

  • CLIA Code: 25D2068071
  • Facility Name: HICKORY FLAT CLINIC LLC
  • Facility Address: 250 OAK STREET
    HICKORY FLAT, MS
    ZIP 38633
  • Facility Phone: 662 551-6492
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: STEPHANIE E. THOMPSON
  • NPI Number: 1326380189
  • Taxonomy: 261QC1500X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 25D2068071
LAB Type Physician Office
Facility Name HICKORY FLAT CLINIC LLC
Street 250 OAK STREET
City HICKORY FLAT
State MS
ZIP 38633
Phone 662 551-6492
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/28/2023
Certificate Expiration Date 10/27/2025
Facility Type Physician Office
Lab Director STEPHANIE E. THOMPSON

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