CLIA lab
CLIA 25D1102480: Healthstat on Site Clinic/Scan Source
Southaven, MS. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 25D1102480 belongs to Healthstat on Site Clinic/Scan Source in Southaven, MS.
Certificate of Waiver, effective July 20, 2025, expires July 19, 2027.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- July 20, 2025
- Certificate expiration
- July 19, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- July 20, 2009
- Facility type
- Other
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 25D1102480
- Lab name
- Healthstat on Site Clinic/Scan Source
- Address
- 8650 Commerce Drive Suite 100, Southaven, MS 38671
- Phone
- (704) 529-6161
- Fax
- (704) 831-6097
Annual test volume the lab reported
- Waived tests
- 150
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Southaven, MS
- All Children's Clinic, PCCertificate of Compliance, Physician office25D2016215
- Arizona UrologyCertificate of Registration, Physician office25D2336844
- Axon Surgical Center, LLCCertificate of Waiver, Ambulatory surgery center25D2344998
- BMG - Desoto Primary Care AssociatesCertificate of Waiver, Physician office25D2046244
- BMG Idtf Mid South Imaging CenterCertificate of Waiver, Ancillary test site25D2269466
- BMG Southaven Family PracticeCertificate of Waiver, Physician office25D2262142
- Balanced Minds and Wellness PLLCCertificate of Waiver, Physician office25D2346667
- Baptist Memorial HospitalCertificate of Accreditation, Hospital25D0316619
- Baptist Memorial Hospital Union Cty - BccdCertificate of Accreditation, Physician office25D0969587
- Baptist Memorial Medical Group, Inc- DWCCertificate of Waiver, Physician office25D2097401
Related
Questions
What is the CLIA number for Healthstat on Site Clinic/Scan Source in Southaven?
25D1102480, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Healthstat on Site Clinic/Scan Source hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 25D1102480 expire?
The CMS file lists July 19, 2027 as the certificate expiration date; the certificate took effect July 20, 2025.