25D2175734 CLIA NUMBER - FAST PACE MISSISSIPPI, PLLC

Laboratory Demographics

  • CLIA Code: 25D2175734
  • Facility Name: FAST PACE MISSISSIPPI, PLLC
  • Facility Address: 1709 WEST QUITMAN STREET
    IUKA, MS
    ZIP 38852
  • Facility Phone: 662 443-4122
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DANA MARTIN
  • NPI Number: 1407513781
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 25D2175734
LAB Type Physician Office
Facility Name FAST PACE MISSISSIPPI, PLLC
Street 1709 WEST QUITMAN STREET
City IUKA
State MS
ZIP 38852
Phone 662 443-4122
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/27/2023
Certificate Expiration Date 11/26/2025
Facility Type Physician Office
Lab Director DANA MARTIN

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