25D2227684 CLIA NUMBER - FAST PACE MISSISSIPPI, PLLC

Laboratory Demographics

  • CLIA Code: 25D2227684
  • Facility Name: FAST PACE MISSISSIPPI, PLLC
  • Facility Address: 1417 HWY 1 SOUTH
    GREENVILLE, MS
    ZIP 38701
  • Facility Phone: 662 430-2451
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DANA MARTIN
  • NPI Number: 1326705518
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 25D2227684
LAB Type Physician Office
Facility Name FAST PACE MISSISSIPPI, PLLC
Street 1417 HWY 1 SOUTH
City GREENVILLE
State MS
ZIP 38701
Phone 662 430-2451
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/15/2025
Certificate Expiration Date 6/14/2027
Facility Type Physician Office
Lab Director DANA MARTIN

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