25D2166244 CLIA NUMBER - FAST PACE MISSISSIPPI, PLLC

Laboratory Demographics

  • CLIA Code: 25D2166244
  • Facility Name: FAST PACE MISSISSIPPI, PLLC
  • Facility Address: 2121 GRAND AVENUE
    YAZOO CITY, MS
    ZIP 39194
  • Facility Phone: 662 716-8071
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DANA MARTIN
  • NPI Number: 1821755109
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 25D2166244
LAB Type Physician Office
Facility Name FAST PACE MISSISSIPPI, PLLC
Street 2121 GRAND AVENUE
City YAZOO CITY
State MS
ZIP 39194
Phone 662 716-8071
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/14/2025
Certificate Expiration Date 5/13/2027
Facility Type Physician Office
Lab Director DANA MARTIN

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