25D2170845 CLIA NUMBER - MAGNOLIA BEHAVIORAL HEALTH CLINIC

Laboratory Demographics

CLIA Number: 25D2170845

Facility Name: MAGNOLIA BEHAVIORAL HEALTH CLINIC

Facility Address:
212 ALCORN DRIVE
CORINTH, MS
ZIP 38834
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Facility Phone Number: 662 293-7635

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1821257767

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	25D2170845
LAB Type	Physician Office
Facility Name	MAGNOLIA BEHAVIORAL HEALTH CLINIC
Street	212 ALCORN DRIVE
City	CORINTH
State	MS
ZIP	38834
Phone	662 293-7635
CertificateType	4
CertificateEffectiveDate	8/20/2023
CertificateExpirationDate	8/19/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024