42D0249458 CLIA NUMBER - SANDHILLS PEDIATRIC & ADOLESCENT CLINIC

Laboratory Demographics

  • CLIA Code: 42D0249458
  • Facility Name: SANDHILLS PEDIATRIC & ADOLESCENT CLINIC
  • Facility Address: 1749 MARSHALL STREET
    COLUMBIA, SC
    ZIP 29203
  • Facility Phone: 803 788-4886
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: JONATHAN BROCK
  • NPI Number: 1730168121
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 42D0249458
LAB Type Physician Office
Facility Name SANDHILLS PEDIATRIC & ADOLESCENT CLINIC
Street 1749 MARSHALL STREET
City COLUMBIA
State SC
ZIP 29203
Phone 803 788-4886
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 9/17/2023
Certificate Expiration Date 10/31/2025
Facility Type Physician Office
Lab Director JONATHAN BROCK

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