25D2232031 CLIA NUMBER - OLIVE BRANCH FIRE DEPARTMENT AMBULANCE

Laboratory Demographics

  • CLIA Code: 25D2232031
  • Facility Name: OLIVE BRANCH FIRE DEPARTMENT AMBULANCE
  • Facility Address: 9245 PIGEON ROOST RD
    OLIVE BRANCH, MS
    ZIP 38654
  • Facility Phone: 662 890-7376
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: GLENDA GARCIA
  • NPI Number: 1306303011
  • Taxonomy: 363LP0808X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 25D2232031
LAB Type Ambulance
Facility Name OLIVE BRANCH FIRE DEPARTMENT AMBULANCE
Street 9245 PIGEON ROOST RD
City OLIVE BRANCH
State MS
ZIP 38654
Phone 662 890-7376
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/10/2025
Certificate Expiration Date 8/9/2027
Facility Type Ambulance
Lab Director GLENDA GARCIA

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