25D2269466 CLIA NUMBER - BMG IDTF MID SOUTH IMAGING CENTER

Laboratory Demographics

  • CLIA Code: 25D2269466
  • Facility Name: BMG IDTF MID SOUTH IMAGING CENTER
  • Facility Address: 363 SOUTHCREST CIRCLE STE 102
    SOUTHAVEN, MS
    ZIP 38671
  • Facility Phone: 662 772-4615
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BETH A. BRITT
  • NPI Number: 1245966324
  • Taxonomy: 261Q00000X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 25D2269466
LAB Type Physician Office
Facility Name BMG IDTF MID SOUTH IMAGING CENTER
Street 363 SOUTHCREST CIRCLE STE 102
City SOUTHAVEN
State MS
ZIP 38671
Phone 662 772-4615
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/27/2024
Certificate Expiration Date 9/26/2026
Facility Type Physician Office
Lab Director BETH A. BRITT

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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