25D2224224 CLIA NUMBER - RIGHT TRACK MG/BEACON BEHAVIORAL SUPPORT SERVICES

Laboratory Demographics

  • CLIA Code: 25D2224224
  • Facility Name: RIGHT TRACK MG/BEACON BEHAVIORAL SUPPORT SERVICES
  • Facility Address: 117 FOUNTAINS RD STE 1
    MADISON, MS
    ZIP 39110
  • Facility Phone: 601 499-1105
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. R STEPHEN PANNEL
  • NPI Number: 1770717449
  • Taxonomy: 2084P0800X - Psychiatry & Neurology

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CLIA Record

Field Name Field Value
CLIA Number 25D2224224
LAB Type Physician Office
Facility Name RIGHT TRACK MG/BEACON BEHAVIORAL SUPPORT SERVICES
Street 117 FOUNTAINS RD STE 1
City MADISON
State MS
ZIP 39110
Phone 601 499-1105
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/12/2025
Certificate Expiration Date 5/11/2027
Facility Type Physician Office
Lab Director DR. R STEPHEN PANNEL

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