25D2193847 CLIA NUMBER - BRICK CITY DRUGS

Laboratory Demographics

  • CLIA Code: 25D2193847
  • Facility Name: BRICK CITY DRUGS
  • Facility Address: 159 FOUNTAINS BLVD STE A
    MADISON, MS
    ZIP 39110
  • Facility Phone: 769 231-1400
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOHN D. HEGI
  • NPI Number: 1316558851
  • Taxonomy: 3336C0004X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 25D2193847
LAB Type Pharmacy
Facility Name BRICK CITY DRUGS
Street 159 FOUNTAINS BLVD STE A
City MADISON
State MS
ZIP 39110
Phone 769 231-1400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/25/2024
Certificate Expiration Date 9/24/2026
Facility Type Pharmacy
Lab Director JOHN D. HEGI

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