25D2174340 CLIA NUMBER - SPRINGRIDGE MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 25D2174340
  • Facility Name: SPRINGRIDGE MEDICAL CLINIC
  • Facility Address: 507 SPRINGRIDGE ROAD, SUITE A
    CLINTON, MS
    ZIP 39056
  • Facility Phone: 601 708-1414
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. SHINITA R. DUDLEY
  • NPI Number: 1689217978
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 25D2174340
LAB Type Physician Office
Facility Name SPRINGRIDGE MEDICAL CLINIC
Street 507 SPRINGRIDGE ROAD, SUITE A
City CLINTON
State MS
ZIP 39056
Phone 601 708-1414
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/30/2023
Certificate Expiration Date 10/29/2025
Facility Type Physician Office
Lab Director DR. SHINITA R. DUDLEY

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