42D0252855 CLIA NUMBER - UPSTATE OB/GYN ASSOC PA

Laboratory Demographics

  • CLIA Code: 42D0252855
  • Facility Name: UPSTATE OB/GYN ASSOC PA
  • Facility Address: 135 COMMONWEALTH DRIVE, SUITE 300
    GREENVILLE, SC
    ZIP 29615
  • Facility Phone: 864 271-9780
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: PERRY B. DELOACH
  • NPI Number: 1316022973
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 42D0252855
LAB Type Physician Office
Facility Name UPSTATE OB/GYN ASSOC PA
Street 135 COMMONWEALTH DRIVE, SUITE 300
City GREENVILLE
State SC
ZIP 29615
Phone 864 271-9780
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 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director PERRY B. DELOACH

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