Organization · NPI-2

Magnolia Analytical, LLC

Clinical Medical Laboratory · Hattiesburg, MS

NPI number1922374420
StatusActive
Last updated in NPPESMar 29, 2012

Details

NPI
1922374420
Entity type
Organization (NPI-2)
Legal business name
Magnolia Analytical, LLC
Organization subpart
No
Enumeration date
Mar 29, 2012
Last updated
Mar 29, 2012

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
291U00000X Clinical Medical Laboratory––Yes

Practice location

1 Lincoln Pkwy
Suite 100
Hattiesburg, MS 39402-3262

Phone 601-579-4466

Mailing address

1 Lincoln Pkwy
Suite 100
Hattiesburg, MS 39402-3262

Authorized official

Shelley Gendusa
Member
6016066366

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