25D2277739 CLIA NUMBER - CHILDREN'S INTERNATIONAL MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 25D2277739
  • Facility Name: CHILDREN'S INTERNATIONAL MEDICAL GROUP
  • Facility Address: 345 BUCK KIRKLAND RD
    POPLARVILLE, MS
    ZIP 39470
  • Facility Phone: 601 746-4648
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. EDUARDO J. HERNANDEZ
  • NPI Number: 1629778147
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 25D2277739
LAB Type Physician Office
Facility Name CHILDREN'S INTERNATIONAL MEDICAL GROUP
Street 345 BUCK KIRKLAND RD
City POPLARVILLE
State MS
ZIP 39470
Phone 601 746-4648
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/3/2025
Certificate Expiration Date 3/2/2027
Facility Type Physician Office
Lab Director DR. EDUARDO J. HERNANDEZ

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