FAIRY WINGS LABORATORY AND SPECIALTY SERVICES
NPI 1316517329
Clinic/Center - Health Service in Gulfport, MS
NPI Status: Active since June 30, 2021
Contact Information
549 E PASS RD STE J
GULFPORT, MS
ZIP 39507
Phone: (228) 284-5671
Fax: (228) 284-5724
- Organization
- Clinic/Center
- Health Service
- CLIA Number: 25D2232943
- CLIA Cert. Type: Mobile Laboratory
- CLIA Exp. Date: 08-17-2025
About FAIRY WINGS LABORATORY AND SPECIALTY SERVICES
This page provides the complete NPI Profile along with additional information for Fairy Wings Laboratory And Specialty Services, a provider established in Gulfport, Mississippi operating as a Clinic/center, focusing in health service . The healthcare provider is registered in the NPI registry with number 1316517329 assigned on June 2021. The practitioner's primary taxonomy code is 261QH0100X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The provider's is doing business as Fairy Wings Laboratory And Specialty Services. The authorized official of this NPI record is Ms. Tomieko Threadgill Phlebot, Ncma, Ncmla (Owner)
- NPI
- 1316517329
- Provider Legal Name
- FAIRY WINGS MOBILE PHLEBOTOMY SERVICE LLC
- Other Organization Name
- FAIRY WINGS LABORATORY AND SPECIALTY SERVICES
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 549 E PASS RD STE J GULFPORT, MS 39507
- Location Phone
- (228) 284-5671
- Location Fax
- (228) 284-5724
- Mailing Address
- 549 E PASS RD STE J GULFPORT, MS 39507
- Mailing Phone
- (228) 284-4176
- Mailing Fax
- (228) 284-5724
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 06-30-2021
- Last Update Date
- 04-11-2023
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Health Service
- Taxonomy Code
- 261QH0100X
- Type
- Ambulatory Health Care Facilities
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 291U00000X | Laboratories | Clinical Medical Laboratory | |
| 2 | 332B00000X | Suppliers | Durable Medical Equipment & Medical Supplies | |
| 3 | 343900000X | Transportation Services | Non-emergency Medical Transport (VAN) | |
| 4 | 347C00000X | Transportation Services | Private Vehicle |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 25D2232943
- Facility Type
- Mobile Laboratory
- Certificate Effective Date
- August 18, 2023
- Certificate Expiration Date
- August 17, 2025
- Laboratory Director
- TOMIEKO L. THREADGILL
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Fairy Wings Laboratory And Specialty Services to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for FAIRY WINGS LABORATORY AND SPECIALTY SERVICES
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 3 | 1 | 6 | 5 | 1 | 7 | 3 | 2 | 9 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 3 | 2 | 6 | 10 | 1 | 14 | 3 | 4 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 3 + 2 + 6 + 1 + 0 + 1 + 1 + 4 + 3 + 4 + 24 = 51 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 51 = 9 | 9 | ||||||||
The NPI number 1316517329 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following provider is registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1972120525 | MS. TOMIEKO THREADGILL PHLEBO, MA, CMLA Individual | Technician, Pathology (Phlebotomy) | 549 E PASS RD STE J GULFPORT, MS 39507 (228) 284-4176 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1316517329, enumerated in the NPI registry as an "organization" on June 30, 2021
The provider is located at 549 E Pass Rd Ste J Gulfport, Ms 39507 and the phone number is (228) 284-5671
This medical organization specializes in Clinic/Center with taxonomy code 261QH0100X with a focus in Health Service
The provider's CLIA number is 25D2232943 for a "mobile laboratory" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on June 30, 2021. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.