25D2267273 CLIA NUMBER - PINE STREET FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 25D2267273
  • Facility Name: PINE STREET FAMILY MEDICINE
  • Facility Address: 908 W PINE ST
    HATTIESBURG, MS
    ZIP 39401
  • Facility Phone: 601 579-3022
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: DR. SHOMARI D. THOMPSON
  • NPI Number: 1578283776
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 25D2267273
LAB Type Physician Office
Facility Name PINE STREET FAMILY MEDICINE
Street 908 W PINE ST
City HATTIESBURG
State MS
ZIP 39401
Phone 601 579-3022
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 5/24/2025
Certificate Expiration Date 5/23/2027
Facility Type Physician Office
Lab Director DR. SHOMARI D. THOMPSON

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