Phase2 Labs Mississippi LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

PHASE2 LABS MISSISSIPPI LLC

Doing business as

Phase2 Labs Mississippi LLC

Practice address

8727 Northwest Dr Ste C
Southaven, MS 38671-2429

Phone

(615) 367-1208

Fax

(615) 327-9672

NPI assigned

Dec 23, 2024

Organization subpart

No

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

Authorized official

Name

Joseph Torrento

Title

Cfo

Phone

(615) 268-7093

Specialties & licenses 1

Addresses

Other names 1

• Phase2 Labs Mississippi LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Phase2 Labs, LLC

  • Clinical Medical Laboratory
  • Nashville, TN
  • NPI 1760077606

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1734912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734912000000",
    "number": "1790593614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5225 HARDING PL",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372172901",
            "telephone_number": "615-268-7093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8727 NORTHWEST DR STE C",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386712429",
            "telephone_number": "615-367-1208",
            "fax_number": "615-327-9672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHASE2 LABS MISSISSIPPI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-23",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A",
        "authorized_official_last_name": "TORRENTO",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "615-268-7093"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phase2 Labs Mississippi LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Calleen Patricia Petersen, LMSW
• John S Petrides
• Tracey F Petrides, M.D.
• Blanche Foshee' Petty, APRN
• Pharmcare USA of Memphis, Inc (Pharm Care Inc)
• Phillips County Transportation (P C Trans)
• Galen Phillips, NP
• Samantha Phillips, COTA/L
• Physiotherapy Associates
• Physiotherapy Associates Inc (Physiotherapy Associates-Southhaven)

• Clinical Medical Laboratory in Southaven, MS
• Providers in Southaven, 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 Dec 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.