32D0686202 CLIA NUMBER - BLUE RIDGE PEDIATRICS, LLC

Laboratory Demographics

  • CLIA Code: 32D0686202
  • Facility Name: BLUE RIDGE PEDIATRICS, LLC
  • Facility Address: 457-B HIGHWAY 123 BYPASS
    SENECA, SC
    ZIP 29678
  • Facility Phone: 864 888-4464
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CAREY M. GULLY
  • NPI Number: 1457324907
  • Taxonomy: 2080A0000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 32D0686202
LAB Type Physician Office
Facility Name BLUE RIDGE PEDIATRICS, LLC
Street 457-B HIGHWAY 123 BYPASS
City SENECA
State SC
ZIP 29678
Phone 864 888-4464
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/23/2025
Certificate Expiration Date 4/22/2027
Facility Type Physician Office
Lab Director CAREY M. GULLY

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This page was last updated on: 9/29/2025