25D2313822 CLIA NUMBER - GREGORY GORDON, MD, PLLC

Laboratory Demographics

  • CLIA Code: 25D2313822
  • Facility Name: GREGORY GORDON, MD, PLLC
  • Facility Address: 300 CASTLEWOODS BLVD # 8
    BRANDON, MS
    ZIP 39047
  • Facility Phone: 601 622-1574
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RON MILONE
  • NPI Number: 1699210401
  • Taxonomy: 2084P0800X - Psychiatry & Neurology

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CLIA Record

Field Name Field Value
CLIA Number 25D2313822
LAB Type Physician Office
Facility Name GREGORY GORDON, MD, PLLC
Street 300 CASTLEWOODS BLVD # 8
City BRANDON
State MS
ZIP 39047
Phone 601 622-1574
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/7/2024
Certificate Expiration Date 11/6/2026
Facility Type Physician Office
Lab Director RON MILONE

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