42D0250876 CLIA NUMBER - LOWCOUNTRY UROLOGY CLINICS PA

Laboratory Demographics

CLIA Number: 42D0250876

Facility Name: LOWCOUNTRY UROLOGY CLINICS PA

Facility Address:
2687 LAKE PARK DRIVE
NORTH CHARLESTON, SC
ZIP 29406
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Facility Phone Number: 843 572-1010

Facility Type: Physician Office

Certificate Type: Certificate of Compliance

NPI Number: 1790972685

Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

CLIA Record

Field Name	Field Value
CLIA Number	42D0250876
LAB Type	Physician Office
Facility Name	LOWCOUNTRY UROLOGY CLINICS PA
Street	2687 LAKE PARK DRIVE
City	NORTH CHARLESTON
State	SC
ZIP	29406
Phone	843 572-1010
CertificateType	2
CertificateEffectiveDate	12/29/2019
CertificateExpirationDate	4/30/2024
FacilityType	Compliance

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This page was last updated on: 4/23/2024