42D0249575 CLIA NUMBER - PROVIDENCE FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 42D0249575
  • Facility Name: PROVIDENCE FAMILY PRACTICE
  • Facility Address: 115 BLARNEY DRIVE SUITE 212
    COLUMBIA, SC
    ZIP 29223
  • Facility Phone: 803 254-5171
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: FRAMPTON W. HENDERSON JR
  • NPI Number: 1528066115
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 42D0249575
LAB Type Physician Office
Facility Name PROVIDENCE FAMILY PRACTICE
Street 115 BLARNEY DRIVE SUITE 212
City COLUMBIA
State SC
ZIP 29223
Phone 803 254-5171
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 7/3/2024
Certificate Expiration Date 7/2/2026
Facility Type Physician Office
Lab Director FRAMPTON W. HENDERSON JR

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