CMS-1500 Box 24J / 33a • NPI
1255473906
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
291U00000X (CMS 69)
CLIA-Certified Diagnostic Medical & Pathology Laboratory
Box 32 Service Location & ZIP+4
602 NJEFFERSON STREET, MACON, MS, 39341
Official NPPES Practice Location
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1255473906 (MACON CLINICAL LABORATORY, INC.) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1255473906 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | MACON CLINICAL LABORATORY, INC. |
| Plain-English Specialty | CLIA-Certified Diagnostic Medical & Pathology Laboratory NUCC Code: 291U00000X (Clinical Medical Laboratory) |
| Certifying / Licensing Body | CMS CLIA / College of American Pathologists (CAP) |
| Practice Location Address | 602 NJEFFERSON STREET, MACON, MS, 39341 |
| Practice Telephone / Fax | Tel: (662) 726-5831 | Fax: (662) 726-4638 |
| Administrative Mailing Address | PO BOX 306, MACON, MS, 39341-0306 |
| Enumeration & Last Sync | Enumerated: 2007-02-12 | CMS Record Updated: 2020-08-22 |
| Authorized Official | ERNEST STUART (Administrator) |
Clinic Location, Accessibility & Directions
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Plain-English Taxonomy & CMS Crosswalk (291U00000X)
What Does Taxonomy Code 291U00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 291U00000X translates to:
"CLIA-Certified Diagnostic Medical & Pathology Laboratory"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (MACON CLINICAL LABORATORY, INC.)
Typical CPT / Diagnostic Procedures:- Complete Blood Count (CBC) with Automated Differential (CPT 85025)
- Comprehensive Metabolic Panel (CMP), Fractionated Bilirubin & Hepatic Panel
- Quantitative Urine Culture & Colony Count (≥ 10⁵ CFU/mL) with Antibiotic Susceptibility
- HbA1c, Lipid Panel, TSH & High-Sensitivity Troponin Assays
- Diagnostic Reagent Panels & CLSI Antimicrobial Susceptibility Disks/MIC Cards
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
291U00000X — Clinical Medical LaboratoryPlain English: CLIA-Certified Diagnostic Medical & Pathology Laboratory | State: MS | License: 25D0318770 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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