25D2318579 CLIA NUMBER - RELIEF CLINIC, THE

Laboratory Demographics

  • CLIA Code: 25D2318579
  • Facility Name: RELIEF CLINIC, THE
  • Facility Address: 102 N BURKE AVENUE
    LONG BEACH, MS
    ZIP 39560
  • Facility Phone: 228 284-2176
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. MALLORY BLAKESLEE
  • NPI Number: 1922821123
  • Taxonomy: 207QA0505X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 25D2318579
LAB Type Physician Office
Facility Name RELIEF CLINIC, THE
Street 102 N BURKE AVENUE
City LONG BEACH
State MS
ZIP 39560
Phone 228 284-2176
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/13/2025
Certificate Expiration Date 2/12/2027
Facility Type Physician Office
Lab Director DR. MALLORY BLAKESLEE

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