25D2185231 CLIA NUMBER - TARA PHARMACY SE LLC

Laboratory Demographics

  • CLIA Code: 25D2185231
  • Facility Name: TARA PHARMACY SE LLC
  • Facility Address: 110 METROPLEX BLVD STE H
    PEARL, MS
    ZIP 39208
  • Facility Phone: 601 664-1664
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JAMES R. COX
  • NPI Number: 1821292731
  • Taxonomy: 3336L0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 25D2185231
LAB Type Pharmacy
Facility Name TARA PHARMACY SE LLC
Street 110 METROPLEX BLVD STE H
City PEARL
State MS
ZIP 39208
Phone 601 664-1664
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/1/2024
Certificate Expiration Date 5/31/2026
Facility Type Pharmacy
Lab Director JAMES R. COX

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