Provider Demographics
NPI:1255060042
Name:COMPASS LABORATORY SERVICES OF MISSISSIPPI LLC
Entity type:Organization
Organization Name:COMPASS LABORATORY SERVICES OF MISSISSIPPI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANNIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:CHAPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-348-5774
Mailing Address - Street 1:7900 AIRWAYS BLVD STE 6
Mailing Address - Street 2:
Mailing Address - City:SOUTHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:38671-4113
Mailing Address - Country:US
Mailing Address - Phone:901-948-5774
Mailing Address - Fax:901-948-5738
Practice Address - Street 1:7900 AIRWAYS BLVD STE 6
Practice Address - Street 2:
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38671-4113
Practice Address - Country:US
Practice Address - Phone:901-348-5774
Practice Address - Fax:901-348-5738
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-07
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory