25D2150425 CLIA NUMBER - FAST PACE MISSISSIPPI, PLLC

Laboratory Demographics

  • CLIA Code: 25D2150425
  • Facility Name: FAST PACE MISSISSIPPI, PLLC
  • Facility Address: 616 HWY 82
    INDIANOLA, MS
    ZIP 38751
  • Facility Phone: 662 635-8680
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DANA MARTIN
  • NPI Number: 1881353597
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 25D2150425
LAB Type Physician Office
Facility Name FAST PACE MISSISSIPPI, PLLC
Street 616 HWY 82
City INDIANOLA
State MS
ZIP 38751
Phone 662 635-8680
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/25/2024
Certificate Expiration Date 6/24/2026
Facility Type Physician Office
Lab Director DANA MARTIN

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