25D2299373 CLIA NUMBER - SINGING RIVER MEDICAL CLINIC PASS ROAD

Laboratory Demographics

  • CLIA Code: 25D2299373
  • Facility Name: SINGING RIVER MEDICAL CLINIC PASS ROAD
  • Facility Address: 1924 E PASS ROAD
    GULFPORT, MS
    ZIP 39507
  • Facility Phone: 228 388-4862
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PAUL G. MATHERNE
  • NPI Number: 1730245739
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 25D2299373
LAB Type Physician Office
Facility Name SINGING RIVER MEDICAL CLINIC PASS ROAD
Street 1924 E PASS ROAD
City GULFPORT
State MS
ZIP 39507
Phone 228 388-4862
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/20/2024
Certificate Expiration Date 2/19/2026
Facility Type Physician Office
Lab Director PAUL G. MATHERNE

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