25D2176198 CLIA NUMBER - FAST PACE MISSISSIPPI, PLLC

Laboratory Demographics

  • CLIA Code: 25D2176198
  • Facility Name: FAST PACE MISSISSIPPI, PLLC
  • Facility Address: 1400 HIGHWAY 72 E
    CORINTH, MS
    ZIP 38834
  • Facility Phone: 662 664-5538
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DANA MARTIN
  • NPI Number: 1124785407
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 25D2176198
LAB Type Physician Office
Facility Name FAST PACE MISSISSIPPI, PLLC
Street 1400 HIGHWAY 72 E
City CORINTH
State MS
ZIP 38834
Phone 662 664-5538
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/10/2023
Certificate Expiration Date 12/9/2025
Facility Type Physician Office
Lab Director DANA MARTIN

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