25D2287583 CLIA NUMBER - BEANSTALK PEDIATRICS PLLC

Laboratory Demographics

  • CLIA Code: 25D2287583
  • Facility Name: BEANSTALK PEDIATRICS PLLC
  • Facility Address: 320 W JACKSON ST
    RIDGELAND, MS
    ZIP 39157
  • Facility Phone: 769 567-1527
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. CONSTANCE BARNES-WOODS
  • NPI Number: 1740967520
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 25D2287583
LAB Type Physician Office
Facility Name BEANSTALK PEDIATRICS PLLC
Street 320 W JACKSON ST
City RIDGELAND
State MS
ZIP 39157
Phone 769 567-1527
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/15/2025
Certificate Expiration Date 8/14/2027
Facility Type Physician Office
Lab Director DR. CONSTANCE BARNES-WOODS

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