OrganizationActive
Main Street Clinical Laboratory, Inc
NPI 1174859714 · Clinical Medical Laboratory · Southaven, MS
Main Street Clinical Laboratory, Inc is a Clinical Medical Laboratory organization in Southaven, MS (NPI 1174859714).
Provider details
- NPI number
- 1174859714
- Entity type
- Organization
- Primary specialty
- Clinical Medical LaboratoryLaboratories
- Organization subpart
- No
- Authorized official
- Jay Schryver, Vp of Operations(303) 371-0073
Specialties & taxonomies
Laboratories
Profile Score
Detailed profile(84/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
16 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
8727 Northwest Dr
Southaven, MS 38671-2429
Phone: (303) 371-0073
Street-level locationGet directions
Mailing address
12075 E 45th Ave
Denver, CO 80239-3123
Registry dates
- Enumerated
- 2009-11-01
- Last updated
- 2015-09-21
Frequently asked questions
- What is Main Street Clinical Laboratory, Inc's NPI number?
- Main Street Clinical Laboratory, Inc's National Provider Identifier (NPI) is 1174859714, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Main Street Clinical Laboratory, Inc?
- Main Street Clinical Laboratory, Inc is classified in the NPPES registry as Clinical Medical Laboratory (Laboratories).
- Where is Main Street Clinical Laboratory, Inc located?
- Main Street Clinical Laboratory, Inc's practice location on file with NPPES is 8727 Northwest Dr, Southaven, MS 38671-2429.
- What is Main Street Clinical Laboratory, Inc's phone number?
- The practice phone number listed in the NPPES registry for Main Street Clinical Laboratory, Inc is (303) 371-0073.
- Who is the authorized official for Main Street Clinical Laboratory, Inc?
- The authorized official listed on Main Street Clinical Laboratory, Inc's NPPES record is Jay Schryver, Vp of Operations. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Main Street Clinical Laboratory, Inc's NPI active?
- Yes — Main Street Clinical Laboratory, Inc's NPI (1174859714) is active in the NPPES registry as of the last update on 2015-09-21.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.