25D2072433 CLIA NUMBER - PETAL SCHOOL CLINIC

Laboratory Demographics

  • CLIA Code: 25D2072433
  • Facility Name: PETAL SCHOOL CLINIC
  • Facility Address: 36 PANTHER STADIUM DRIVE
    PETAL, MS
    ZIP 39465
  • Facility Phone: 601 450-1729
  • Facility Type: School/Student Health Service
  • Facility Type: Microscopy
  • Lab Director: CATHERINE M. THOMAS
  • NPI Number: 1356563605
  • Taxonomy: 163W00000X - Registered Nurse

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CLIA Record

Field Name Field Value
CLIA Number 25D2072433
LAB Type School/Student Health Service
Facility Name PETAL SCHOOL CLINIC
Street 36 PANTHER STADIUM DRIVE
City PETAL
State MS
ZIP 39465
Phone 601 450-1729
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 1/30/2024
Certificate Expiration Date 1/29/2026
Facility Type School/Student Health Service
Lab Director CATHERINE M. THOMAS

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