25D2070444 CLIA NUMBER - MADISON PHYSICIAN SURGERY CENTER, LLC

Laboratory Demographics

  • CLIA Code: 25D2070444
  • Facility Name: MADISON PHYSICIAN SURGERY CENTER, LLC
  • Facility Address: 4510 LAKELAND DR
    FLOWOOD, MS
    ZIP 39232
  • Facility Phone: 601 605-5393
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: MEREDITH WARF
  • NPI Number: 1073946216
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 25D2070444
LAB Type Ambulatory Surgery Center
Facility Name MADISON PHYSICIAN SURGERY CENTER, LLC
Street 4510 LAKELAND DR
City FLOWOOD
State MS
ZIP 39232
Phone 601 605-5393
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/17/2023
Certificate Expiration Date 12/16/2025
Facility Type Ambulatory Surgery Center
Lab Director MEREDITH WARF

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