Organization
MAGNOLIA ANALYTICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLEY GENDUSA (MEMBER)
(601) 606-6366
Entity
Organization
Contact information
Practice address
1 LINCOLN PKWY, SUITE 100, HATTIESBURG, MS 39402-3262
(601) 579-4466
Mailing address
1 LINCOLN PKWY, SUITE 100, HATTIESBURG, MS 39402-3262
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
03/29/2012
Last updated
03/29/2012
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