25D2270899 CLIA NUMBER - UROGYN SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 25D2270899
  • Facility Name: UROGYN SURGERY CENTER
  • Facility Address: 160 FOUNTAINS BLVD STE C
    MADISON, MS
    ZIP 39110
  • Facility Phone: 601 391-2525
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: ELIZABETH HENDERSON
  • NPI Number: 1558007773
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 25D2270899
LAB Type Ambulatory Surgery Center
Facility Name UROGYN SURGERY CENTER
Street 160 FOUNTAINS BLVD STE C
City MADISON
State MS
ZIP 39110
Phone 601 391-2525
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/24/2024
Certificate Expiration Date 10/23/2026
Facility Type Ambulatory Surgery Center
Lab Director ELIZABETH HENDERSON

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