42D0251086 CLIA NUMBER - LIBERTY DOCTORS DBA CAROLINA FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 42D0251086
  • Facility Name: LIBERTY DOCTORS DBA CAROLINA FAMILY MEDICINE
  • Facility Address: 100 SPRING HALL DR
    GOOSE CREEK, SC
    ZIP 29445
  • Facility Phone: 843 442-5908
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DONALD HANNA
  • NPI Number: 1063954956
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 42D0251086
LAB Type Physician Office
Facility Name LIBERTY DOCTORS DBA CAROLINA FAMILY MEDICINE
Street 100 SPRING HALL DR
City GOOSE CREEK
State SC
ZIP 29445
Phone 843 442-5908
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 12/2/2024
Certificate Expiration Date 12/1/2026
Facility Type Physician Office
Lab Director DONALD HANNA

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