25D2253128 CLIA NUMBER - FAST PACE MISSISSIPPI, PLLC

Laboratory Demographics

  • CLIA Code: 25D2253128
  • Facility Name: FAST PACE MISSISSIPPI, PLLC
  • Facility Address: 6244 HIGHWAY 305 N
    OLIVE BRANCH, MS
    ZIP 38654
  • Facility Phone: 931 253-1110
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DANA MARTIN
  • NPI Number: 1427715770
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 25D2253128
LAB Type Physician Office
Facility Name FAST PACE MISSISSIPPI, PLLC
Street 6244 HIGHWAY 305 N
City OLIVE BRANCH
State MS
ZIP 38654
Phone 931 253-1110
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/17/2024
Certificate Expiration Date 2/16/2026
Facility Type Physician Office
Lab Director DANA MARTIN

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