25D2288653 CLIA NUMBER - MED360 LLC

Laboratory Demographics

  • CLIA Code: 25D2288653
  • Facility Name: MED360 LLC
  • Facility Address: 407 SUMRALL RD
    COLUMBIA, MS
    ZIP 39429
  • Facility Phone: 601 345-5424
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MICHAEL SCHEPEMAKER
  • NPI Number: 1831819820
  • Taxonomy: 261QM2500X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 25D2288653
LAB Type Physician Office
Facility Name MED360 LLC
Street 407 SUMRALL RD
City COLUMBIA
State MS
ZIP 39429
Phone 601 345-5424
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/29/2025
Certificate Expiration Date 8/28/2027
Facility Type Physician Office
Lab Director MICHAEL SCHEPEMAKER

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