42D0019897 CLIA NUMBER - MCLEOD FAMILY MEDICINE KINGSTREE

Laboratory Demographics

  • CLIA Code: 42D0019897
  • Facility Name: MCLEOD FAMILY MEDICINE KINGSTREE
  • Facility Address: 1200 NORTH LONGSTREET STREET
    KINGSTREE, SC
    ZIP 29556
  • Facility Phone: 843 355-5459
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROBERT S. EAGERTON
  • NPI Number: 1275689002
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 42D0019897
LAB Type Physician Office
Facility Name MCLEOD FAMILY MEDICINE KINGSTREE
Street 1200 NORTH LONGSTREET STREET
City KINGSTREE
State SC
ZIP 29556
Phone 843 355-5459
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/28/2025
Certificate Expiration Date 9/27/2027
Facility Type Physician Office
Lab Director ROBERT S. EAGERTON

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