Molecular and Diagnostic Testing Labs of America

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MOLECULAR AND DIAGNOSTIC TESTING LABS OF AMERICA

Practice address

1529 Cliff Gookin Blvd
Tupelo, MS 38801-6401

Phone

(901) 412-8934

NPI assigned

Sep 3, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Joseph Campbell

Title

Owner

Phone

(662) 266-2217

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1599091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610582400000",
    "number": "1023622305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1529 CLIFF GOOKIN BLVD",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016401",
            "telephone_number": "901-421-8934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1529 CLIFF GOOKIN BLVD",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016401",
            "telephone_number": "901-412-8934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOLECULAR AND DIAGNOSTIC TESTING LABS OF AMERICA",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-03",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-266-2217"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lori Mize, FNP
• MMSS Ancillary Services Inc
• Pranav Modi, MBBS
• Hollie Dulaney Moffatt, PMHNP-BC
• Rayyan Mohammed, DO
• David Monaghan, M.D.
• Michael Monroe, D.M.D.
• Brandon Montgomery, MD
• Erica Michele Montgomery, MED
• Janet Woods Montgomery, LMSW

• Clinical Medical Laboratory in Tupelo, MS
• Providers in Tupelo, MS by specialty
• Clinical Medical Laboratory in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.