25D2278272 CLIA NUMBER - CHILDREN'S INTERNATIONAL MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 25D2278272
  • Facility Name: CHILDREN'S INTERNATIONAL MEDICAL GROUP
  • Facility Address: 930 MAIN ST
    COLUMBIA, MS
    ZIP 39429
  • Facility Phone: 601 255-3133
  • Facility Type: Independent
  • Facility Type: Waiver
  • Lab Director: DR. EDUARDO J. HERNANDEZ
  • NPI Number: 1164126132
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 25D2278272
LAB Type Independent
Facility Name CHILDREN'S INTERNATIONAL MEDICAL GROUP
Street 930 MAIN ST
City COLUMBIA
State MS
ZIP 39429
Phone 601 255-3133
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/14/2025
Certificate Expiration Date 3/13/2027
Facility Type Independent
Lab Director DR. EDUARDO J. HERNANDEZ

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