42D0683801 CLIA NUMBER - ST FRANCIS PHYSICIANS SERVICES INC DBA PALMETTO GREENVILLE UROLOGY

Laboratory Demographics

  • CLIA Code: 42D0683801
  • Facility Name: ST FRANCIS PHYSICIANS SERVICES INC DBA PALMETTO GREENVILLE UROLOGY
  • Facility Address: 309 W BULTER ROAD
    MAULDIN, SC
    ZIP 29662
  • Facility Phone: 864 294-2131
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: PHILIP FONTENOT
  • NPI Number: 1194006924
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 42D0683801
LAB Type Physician Office
Facility Name ST FRANCIS PHYSICIANS SERVICES INC DBA PALMETTO GREENVILLE UROLOGY
Street 309 W BULTER ROAD
City MAULDIN
State SC
ZIP 29662
Phone 864 294-2131
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 PHILIP FONTENOT

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