Organization
MEDICAL GENETICS LAB
Active
Parent organization
DEPARTMENT OF PREVENTIVE MEDICINE
Organization subpart
Yes
Provider details
NPI number
Legal business name
DEPARTMENT OF PREVENTIVE MEDICINE
Authorized official
MISS SARA LYNN STUBBS (SUPERVISOR BUSINESS SERVICES)
(601) 984-1925
Entity
Organization
Contact information
Practice address
2500 N STATE ST DEPT CGEN, ROOM R622, JACKSON, MS 39216-4500
(601) 984-1925
(601) 984-1916
Mailing address
2500 N STATE ST DEPT CGEN, ROOM R622, JACKSON, MS 39216-4500
(601) 984-1925
(601) 984-1916
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00016106
—
MS
Enumeration date
01/31/2007
Last updated
02/27/2008
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