25D2287498 CLIA NUMBER - UROGYN SURGERY LLC

Laboratory Demographics

CLIA Number: 25D2287498

Facility Name: UROGYN SURGERY LLC

Facility Address:
120 STONE CREEK BLVD STE 800
FLOWOOD, MS
ZIP 39232
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Facility Phone Number: 601 613-4254

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1770271629

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	25D2287498
LAB Type	Ambulatory Surgery Center
Facility Name	UROGYN SURGERY LLC
Street	120 STONE CREEK BLVD STE 800
City	FLOWOOD
State	MS
ZIP	39232
Phone	601 613-4254
CertificateType	4
CertificateEffectiveDate	8/15/2023
CertificateExpirationDate	8/14/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024