25D2148487 CLIA NUMBER - PREMIER SURGICAL CENTER, LLC

Laboratory Demographics

  • CLIA Code: 25D2148487
  • Facility Name: PREMIER SURGICAL CENTER, LLC
  • Facility Address: 160 FOUNTAINS BLVD
    MADISON, MS
    ZIP 39110
  • Facility Phone: 601 391-2525
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: STACY JONES
  • NPI Number: 1093214819
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 25D2148487
LAB Type Ambulatory Surgery Center
Facility Name PREMIER SURGICAL CENTER, LLC
Street 160 FOUNTAINS BLVD
City MADISON
State MS
ZIP 39110
Phone 601 391-2525
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/11/2024
Certificate Expiration Date 5/10/2026
Facility Type Ambulatory Surgery Center
Lab Director STACY JONES

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