25D2118341 CLIA NUMBER - MALLORY MOBILE RV CLINIC

Laboratory Demographics

  • CLIA Code: 25D2118341
  • Facility Name: MALLORY MOBILE RV CLINIC
  • Facility Address: 17280 HWY 17 S
    LEXINGTON, MS
    ZIP 39095
  • Facility Phone: 662 834-1857
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: CLYDE R. CHAPMAN
  • NPI Number: 1508312992
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 25D2118341
LAB Type Mobile Laboratory
Facility Name MALLORY MOBILE RV CLINIC
Street 17280 HWY 17 S
City LEXINGTON
State MS
ZIP 39095
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 Mobile Laboratory
Lab Director CLYDE R. CHAPMAN

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