25D2118339 CLIA NUMBER - MALLORY COMMUNITY HEALTH CENTER-GOODMAN PICKE

Laboratory Demographics

  • CLIA Code: 25D2118339
  • Facility Name: MALLORY COMMUNITY HEALTH CENTER-GOODMAN PICKE
  • Facility Address: 3877 HWY 51
    GOODMAN, MS
    ZIP 39079
  • Facility Phone: 662 834-1857
  • Facility Type: School/Student Health Service
  • Facility Type: Waiver
  • Lab Director: ROZELL CHAPMAN
  • NPI Number: 1104279355
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 25D2118339
LAB Type School/Student Health Service
Facility Name MALLORY COMMUNITY HEALTH CENTER-GOODMAN PICKE
Street 3877 HWY 51
City GOODMAN
State MS
ZIP 39079
Phone 662 834-1857
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/6/2024
Certificate Expiration Date 9/5/2026
Facility Type School/Student Health Service
Lab Director ROZELL CHAPMAN

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