25D2209251 CLIA NUMBER - AMARIS MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 25D2209251
  • Facility Name: AMARIS MEDICAL GROUP
  • Facility Address: 308 N JACKSON ST
    KOSCIUSKO, MS
    ZIP 39090
  • Facility Phone: 662 792-4101
  • Facility Type: Practitioner Other
  • Facility Type: Microscopy
  • Lab Director: ANITA GREER
  • NPI Number: 1285256271
  • Taxonomy: 363L00000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 25D2209251
LAB Type Practitioner Other
Facility Name AMARIS MEDICAL GROUP
Street 308 N JACKSON ST
City KOSCIUSKO
State MS
ZIP 39090
Phone 662 792-4101
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 1/12/2025
Certificate Expiration Date 1/11/2027
Facility Type Practitioner Other
Lab Director ANITA GREER

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