42D0248960 CLIA NUMBER - EAGERTON FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 42D0248960
  • Facility Name: EAGERTON FAMILY PRACTICE
  • Facility Address: 200 EAST HOSPITAL STREET
    MANNING, SC
    ZIP 29102
  • Facility Phone: 803 433-0439
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. ROBERT S. EAGERTON
  • NPI Number: 1770936411
  • Taxonomy: 207Q00000X - Family Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 42D0248960
LAB Type Physician Office
Facility Name EAGERTON FAMILY PRACTICE
Street 200 EAST HOSPITAL STREET
City MANNING
State SC
ZIP 29102
Phone 803 433-0439
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 3/26/2024
Certificate Expiration Date 3/25/2026
Facility Type Physician Office
Lab Director DR. ROBERT S. EAGERTON

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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