25D2081940 CLIA NUMBER - MEMORIAL PHYSICIAN CLINICS - ST MARTIN

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Laboratory Demographics

CLIA Number: 25D2081940

Facility Name: MEMORIAL PHYSICIAN CLINICS - ST MARTIN

Facility Address:
14213 COOK ROAD, BLDG A
OCEAN SPRINGS, MS
ZIP 39564
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Facility Phone Number: 228 575-1600

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1093142598

Taxonomy: 208800000X - Urology
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

CLIA Record

Field Name	Field Value
CLIA Number	25D2081940
LAB Type	Physician Office
Facility Name	MEMORIAL PHYSICIAN CLINICS - ST MARTIN
Street	14213 COOK ROAD, BLDG A
City	OCEAN SPRINGS
State	MS
ZIP	39564
Phone	228 575-1600
CertificateType	3
CertificateEffectiveDate	3/6/2024
CertificateExpirationDate	3/5/2026
FacilityType	PPMP

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This page was last updated on: 4/23/2024