MEDI-LAB DIAGNOSTICS CENTER LLC
NPI 1780303594
Clinical Medical Laboratory in Gulfport, MS

Active since August 24, 2022CLIA Certified · 2 labs
1617 25TH AVE, GULFPORT, MS 39501(804) 896-6177 Get Directions Write a Review

NPPES record last updated: September 18, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Medi-lab Diagnostics Center Llc NPPES

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

MEDI-LAB DIAGNOSTICS CENTER LLC (NPI 1780303594) is a healthcare organization registered as a clinical medical laboratory in Gulfport, Mississippi and active in the NPI registry since August 2022. The organization holds 2 active CLIA laboratory certificates and lists Lakia Janel Gaines, Laboratory Director, as its authorized official.

NPPES Registry Identity

NPI1780303594
Entity TypeOrganization
Primary Taxonomy291U00000X
Legal Business NameMEDI-LAB DIAGNOSTICS CENTER LLC
Location Address1617 25TH AVEGulfport, MS 39501-2834
Mailing Address1617 25th AveGulfport, MS 39501-2834 · (804) 896-6177 · Fax (804) 451-4739
Organization SubpartNo
Authorized OfficialLakia Janel GainesLaboratory Director · (804) 896-6177
Enumeration DateAugust 24, 2022
Last NPPES UpdateSeptember 18, 2023
NPPES CertifiedSeptember 18, 2023
NPI 1780303594 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyClinical Medical LaboratoryLaboratories
Taxonomy Code291U00000X
Definition
(1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology.
Also ListedClinic/Center · Health ServiceTaxonomy 261QH0100X
1617 25TH AVE, Gulfport, MS 39501

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 2

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 25D2253549

Medi-Lab Diagnostic Center LLC · Gulfport, MS
Active · expires Feb 21, 2028
CLIA Number25D2253549
Laboratory TypeTemp Testing Site
Certificate Effective DateFebruary 22, 2026
Certificate Expiration DateFebruary 21, 2028
Laboratory DirectorLakia G. Kelly
Laboratory Phone(804) 896-6177
Laboratory LocationMedi-Lab Diagnostic Center LLC1617 25th Avenue, Office 105, Gulfport, MS 39503
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 49D2293518

Medi-Lab Diagnostic Center LLC · Kilmarnock, VA
Active · expires Nov 8, 2027
CLIA Number49D2293518
Laboratory TypePublic Health Laboratories
Certificate Effective DateNovember 9, 2025
Certificate Expiration DateNovember 8, 2027
Laboratory DirectorLakia Gaines
Laboratory Phone(804) 896-6177
Laboratory LocationMedi-Lab Diagnostic Center LLC77 South Main St, Kilmarnock, VA 22482
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

Counselor (Professional)
1617 25TH AVE
GULFPORT, MS 39501

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 Medi-Lab Diagnostics Center LLC's NPI number?

The NPI number for Medi-Lab Diagnostics Center LLC is 1780303594. It was assigned to this organization in the NPPES registry on August 24, 2022.

Where is Medi-Lab Diagnostics Center LLC located?

Medi-Lab Diagnostics Center LLC is located at 1617 25th Ave, Gulfport, MS 39501. The listed phone number is (804) 896-6177.

What is Medi-Lab Diagnostics Center LLC's specialty?

The primary specialty registered for this NPI is Clinical Medical Laboratory with taxonomy code 291U00000X.

Does Medi-Lab Diagnostics Center LLC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Medi-Lab Diagnostics Center LLC was last updated on September 18, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.