25D2157900 CLIA NUMBER - FRIENDSHIP MEDICAL CLINIC - TUPELO

Laboratory Demographics

  • CLIA Code: 25D2157900
  • Facility Name: FRIENDSHIP MEDICAL CLINIC - TUPELO
  • Facility Address: 4127 W MAIN ST
    TUPELO, MS
    ZIP 38801
  • Facility Phone: 662 269-3191
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: DR. SAMUEL CREEKMORE III
  • NPI Number: 1194339275
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 25D2157900
LAB Type Physician Office
Facility Name FRIENDSHIP MEDICAL CLINIC - TUPELO
Street 4127 W MAIN ST
City TUPELO
State MS
ZIP 38801
Phone 662 269-3191
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 4/11/2025
Certificate Expiration Date 4/10/2027
Facility Type Physician Office
Lab Director DR. SAMUEL CREEKMORE III

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