25D2209251 CLIA NUMBER - AMARIS MEDICAL GROUP

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Laboratory Demographics

CLIA Number: 25D2209251

Facility Name: AMARIS MEDICAL GROUP

Facility Address:
308 N JACKSON ST
KOSCIUSKO, MS
ZIP 39090
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Facility Phone Number: 662 792-4101

Facility Type: Practitioner Other

Certificate Type: Microscopy

NPI Number: 1285256271

Taxonomy: 363L00000X - Nurse Practitioner
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

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
CertificateType	3
CertificateEffectiveDate	1/12/2023
CertificateExpirationDate	1/11/2025
FacilityType	PPMP

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This page was last updated on: 4/23/2024