25D2327868 CLIA NUMBER - SOG SURGERY CENTER LLC

Laboratory Demographics

  • CLIA Code: 25D2327868
  • Facility Name: SOG SURGERY CENTER LLC
  • Facility Address: 723 CONCORDIA AVE SUITE 200
    OXFORD, MS
    ZIP 38655
  • Facility Phone: 662 432-1490
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: BLAKE C. JEFFRIES
  • NPI Number: 1912480070
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 25D2327868
LAB Type Ambulatory Surgery Center
Facility Name SOG SURGERY CENTER LLC
Street 723 CONCORDIA AVE SUITE 200
City OXFORD
State MS
ZIP 38655
Phone 662 432-1490
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/30/2025
Certificate Expiration Date 7/29/2027
Facility Type Ambulatory Surgery Center
Lab Director BLAKE C. JEFFRIES

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