42D0251343 CLIA NUMBER - SOUTHERNMED PEDIATRICS

Laboratory Demographics

CLIA Number: 42D0251343

Facility Name: SOUTHERNMED PEDIATRICS

Facility Address:
312 MIDLAND PARKWAY
SUMMERVILLE, SC
ZIP 29485
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Facility Phone Number: 843 875-6262

Facility Type: Physician Office

Certificate Type: Certificate of Compliance

NPI Number: 1316340839

Taxonomy: 1223G0001X - Dentist
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

CLIA Record

Field Name	Field Value
CLIA Number	42D0251343
LAB Type	Physician Office
Facility Name	SOUTHERNMED PEDIATRICS
Street	312 MIDLAND PARKWAY
City	SUMMERVILLE
State	SC
ZIP	29485
Phone	843 875-6262
CertificateType	2
CertificateEffectiveDate	8/2/2021
CertificateExpirationDate	4/30/2024
FacilityType	Compliance

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