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MALLORY MOBILE RV CLINIC
NPI 1508312992
Clinic/Center - Federally Qualified Health Center (FQHC) in Lexington, MS

Active since August 26, 2016CLIA 25D2118341 · Waiver
17280 HIGHWAY 17, LEXINGTON, MS 39095(662) 834-1857(662) 834-1859 Get Directions Write a Review

NPPES record last updated: December 30, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 30, 2020, Jul 20, 2020, Aug 26, 2016 (3 updates tracked since 2016).

About Mallory Mobile Rv Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MALLORY MOBILE RV CLINIC (NPI 1508312992) is a healthcare organization registered as a federally qualified health center (fqhc) in Lexington, Mississippi and active in the NPI registry since August 2016. The organization holds a CLIA Waiver certificate valid through September 5, 2026 and lists Clyde Rozell Chapman, Chief Exexcutive Officer, as its authorized official.

NPPES Registry Identity

NPI1508312992
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameMALLORY COMMUNITY HEALTH
Location Address17280 HIGHWAY 17Lexington, MS 39095-6614
Mailing AddressPo Box 479Lexington, MS 39095-0479 · (662) 834-1857 · Fax (662) 834-1859
Phone(662) 834-1857
Fax(662) 834-1859
Organization SubpartNo
Authorized OfficialClyde Rozell ChapmanChief Exexcutive Officer · (662) 834-1857
Enumeration DateAugust 26, 2016
Last NPPES UpdateDecember 30, 20203 updates tracked since enumeration
NPPES CertifiedOctober 12, 2020
✔ NPI 1508312992 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
17280 HIGHWAY 17, Lexington, MS 39095
Open in Google Maps ↗

Other Names 1

Other NameMallory Mobile Rv Clinic

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 25D2118341

Mallory Mobile Rv Clinic · Lexington, MS
Active · expires Sep 5, 2026
CLIA Number25D2118341
Laboratory TypeMobile Laboratory
Certificate Effective DateSeptember 6, 2024
Certificate Expiration DateSeptember 5, 2026
Laboratory DirectorClyde R. Chapman
Laboratory Phone(662) 834-1857
Laboratory LocationMallory Mobile Rv Clinic17280 Hwy 17 S, Lexington, MS 39095
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KATHRYN CONNER CARROLL FNP-BC
Nurse Practitioner (Family)
17280 HIGHWAY 17
LEXINGTON, MS 39095
Holmes County (662) 834-1857
AMBER FLY WESTBROOKS L.D.
Dietitian, Registered
17280 HIGHWAY 17
LEXINGTON, MS 39095
Holmes County (662) 834-1857
MALLORY COMMUNITY HEALTH
Clinic/Center (Federally Qualified Health Center (FQHC))
17280 HIGHWAY 17
LEXINGTON, MS 39095
Holmes County (662) 834-1857
MRS. MELANIE EILAND NP
Nurse Practitioner (Family)
17280 HIGHWAY 17
LEXINGTON, MS 39095
Holmes County (662) 834-1857
ABIOLA NIKE OKE MD
Family Medicine
17280 HIGHWAY 17
LEXINGTON, MS 39095
Holmes County (662) 834-1857
LILY FRANCESCA GUASTELLA MD
Family Medicine
17280 HIGHWAY 17
LEXINGTON, MS 39095
Holmes County (662) 834-1857
MALLORY COMMUNITY HEALTH CENTER
Clinic/Center (Federally Qualified Health Center (FQHC))
17280 HIGHWAY 17
LEXINGTON, MS 39095
Holmes County (662) 834-1857
LINDSAY TAYLOR R.D.
Dietitian, Registered
17280 HIGHWAY 17
LEXINGTON, MS 39095
Holmes County (662) 834-1857

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mallory Community Health's NPI number?

The NPI number for Mallory Community Health is 1508312992. It was assigned to this organization in the NPPES registry on August 26, 2016. The provider is also known as Mallory Mobile Rv Clinic.

Where is Mallory Community Health located?

Mallory Community Health is located at 17280 Highway 17, Lexington, MS 39095. The listed phone number is (662) 834-1857.

What is Mallory Community Health's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

Does Mallory Community Health hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 25D2118341) is associated with this NPI, valid through September 5, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Mallory Community Health was last updated on December 30, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.