25D2090287 CLIA NUMBER - SUPERIOR HEALTH AND WELLNESS

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Laboratory Demographics

CLIA Number: 25D2090287

Facility Name: SUPERIOR HEALTH AND WELLNESS

Facility Address:
2085 GOODMAN RD W STE 50
HORN LAKE, MS
ZIP 38637
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Facility Phone Number: 662 253-8459

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1396134151

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	25D2090287
LAB Type	Physician Office
Facility Name	SUPERIOR HEALTH AND WELLNESS
Street	2085 GOODMAN RD W STE 50
City	HORN LAKE
State	MS
ZIP	38637
Phone	662 253-8459
CertificateType	4
CertificateEffectiveDate	6/1/2022
CertificateExpirationDate	5/31/2024
FacilityType	Waiver

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