25D2100623 CLIA NUMBER - MRH MEDICAL GROUP, NP FAMILY MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 25D2100623
  • Facility Name: MRH MEDICAL GROUP, NP FAMILY MEDICAL CLINIC
  • Facility Address: 2300 24TH AVE
    GULFPORT, MS
    ZIP 39501
  • Facility Phone: 228 206-6500
  • Facility Type: Other - HOUSE CALLS
  • Facility Type: Waiver
  • Lab Director: CARRICKA D. THOMAS
  • NPI Number: 1255713889
  • Taxonomy: 207Q00000X - Family Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 25D2100623
LAB Type Other - HOUSE CALLS
Facility Name MRH MEDICAL GROUP, NP FAMILY MEDICAL CLINIC
Street 2300 24TH AVE
City GULFPORT
State MS
ZIP 39501
Phone 228 206-6500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/18/2025
Certificate Expiration Date 8/17/2027
Facility Type Other - HOUSE CALLS
Lab Director CARRICKA D. THOMAS

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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