25D2239717 CLIA NUMBER - IMAGING CENTER FOR EXCELLENCE DBA PREMIER IMAGING

Laboratory Demographics

  • CLIA Code: 25D2239717
  • Facility Name: IMAGING CENTER FOR EXCELLENCE DBA PREMIER IMAGING
  • Facility Address: 1207 HWY 182 W STE A
    STARKVILLE, MS
    ZIP 39759
  • Facility Phone: 662 320-6800
  • Facility Type: Other - IMAGING CENTER
  • Facility Type: Waiver
  • Lab Director: GARY W. SORRELLS
  • NPI Number: 1730281148
  • Taxonomy: 261QR0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 25D2239717
LAB Type Other - IMAGING CENTER
Facility Name IMAGING CENTER FOR EXCELLENCE DBA PREMIER IMAGING
Street 1207 HWY 182 W STE A
City STARKVILLE
State MS
ZIP 39759
Phone 662 320-6800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/13/2025
Certificate Expiration Date 10/12/2027
Facility Type Other - IMAGING CENTER
Lab Director GARY W. SORRELLS

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