25D2121649 CLIA NUMBER - SOUTHERN EYE SURGERY AND LASER CENTER LLC

Laboratory Demographics

  • CLIA Code: 25D2121649
  • Facility Name: SOUTHERN EYE SURGERY AND LASER CENTER LLC
  • Facility Address: 1923 W 10TH ST
    LAUREL, MS
    ZIP 39440
  • Facility Phone: 601 264-3937
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: KIPER C. NELSON
  • NPI Number: 1235316266
  • Taxonomy: 207W00000X - Ophthalmology

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CLIA Record

Field Name Field Value
CLIA Number 25D2121649
LAB Type Ambulatory Surgery Center
Facility Name SOUTHERN EYE SURGERY AND LASER CENTER LLC
Street 1923 W 10TH ST
City LAUREL
State MS
ZIP 39440
Phone 601 264-3937
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/10/2024
Certificate Expiration Date 11/9/2026
Facility Type Ambulatory Surgery Center
Lab Director KIPER C. NELSON

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