42D0249428 CLIA NUMBER - PRISMA HEALTH FAMILY MEDICINE- MIDLANDS DEPARTMENT OF FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 42D0249428
  • Facility Name: PRISMA HEALTH FAMILY MEDICINE- MIDLANDS DEPARTMENT OF FAMILY MEDICINE
  • Facility Address: 3209 COLONIAL DRIVE
    COLUMBIA, SC
    ZIP 29203
  • Facility Phone: 803 434-8422
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. MATTHEW NODELMAN
  • NPI Number: 1154432458
  • Taxonomy: 282N00000X - General Acute Care Hospital

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CLIA Record

Field Name Field Value
CLIA Number 42D0249428
LAB Type Physician Office
Facility Name PRISMA HEALTH FAMILY MEDICINE- MIDLANDS DEPARTMENT OF FAMILY MEDICINE
Street 3209 COLONIAL DRIVE
City COLUMBIA
State SC
ZIP 29203
Phone 803 434-8422
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 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director DR. MATTHEW NODELMAN

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