25D2268715 CLIA NUMBER - MCFATTER FAMILY MEDICAL DBA AFC MADISON

Laboratory Demographics

CLIA Number: 25D2268715

Facility Name: MCFATTER FAMILY MEDICAL DBA AFC MADISON

Facility Address:
1896 MAIN ST
MADISON, MS
ZIP 39110
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Facility Phone Number: 601 750-6693

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1811660293

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	25D2268715
LAB Type	Physician Office
Facility Name	MCFATTER FAMILY MEDICAL DBA AFC MADISON
Street	1896 MAIN ST
City	MADISON
State	MS
ZIP	39110
Phone	601 750-6693
CertificateType	4
CertificateEffectiveDate	9/15/2022
CertificateExpirationDate	9/14/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024