25D2318994 CLIA NUMBER - ELITE MEDICAL SOUTHEAST LLC

Laboratory Demographics

  • CLIA Code: 25D2318994
  • Facility Name: ELITE MEDICAL SOUTHEAST LLC
  • Facility Address: 7165 SWINNEA RD BLDG B, SUITE 2
    SOUTHAVEN, MS
    ZIP 38671
  • Facility Phone: 662 922-2023
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: CHASSITY GREER
  • NPI Number: 1184429284
  • Taxonomy: 363LF0000X - Nurse Practitioner

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 25D2318994
LAB Type Practitioner Other
Facility Name ELITE MEDICAL SOUTHEAST LLC
Street 7165 SWINNEA RD BLDG B, SUITE 2
City SOUTHAVEN
State MS
ZIP 38671
Phone 662 922-2023
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/21/2025
Certificate Expiration Date 2/20/2027
Facility Type Practitioner Other
Lab Director CHASSITY GREER

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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