Organization
HOMETOWN DIAGNOSTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN MCDANIEL (CEO)
(662) 415-6564
Entity
Organization
Contact information
Practice address
TRANSLATIONAL RESEARCH CENTER TR311, 2500 NORTH STATE STREET, JACKSON, MS 39216
(662) 415-6564
Mailing address
104 W SUNSET DR, BRANDON, MS 39042-3535
(662) 415-6564
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
05/21/2019
Last updated
05/21/2019
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