25D2273330 CLIA NUMBER - GORDON MEDICAL ARTS CLINIC

Laboratory Demographics

  • CLIA Code: 25D2273330
  • Facility Name: GORDON MEDICAL ARTS CLINIC
  • Facility Address: 590 SPRINGRIDGE RD
    CLINTON, MS
    ZIP 39056
  • Facility Phone: (601) 488-8101
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. MAXIE L. GORDON
  • NPI Number: 1114105665
  • Taxonomy: 2084P0800X - Psychiatry & Neurology

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CLIA Record

Field Name Field Value
CLIA Number 25D2273330
LAB Type Physician Office
Facility Name GORDON MEDICAL ARTS CLINIC
Street 590 SPRINGRIDGE RD
City CLINTON
State MS
ZIP 39056
Phone 6014888101
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/12/2024
Certificate Expiration Date 12/11/2026
Facility Type Physician Office
Lab Director DR. MAXIE L. GORDON

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This page was last updated on: 5/18/2026