42D0683879 CLIA NUMBER - MCLEOD PRIMARY CARE CLARENDON

Laboratory Demographics

  • CLIA Code: 42D0683879
  • Facility Name: MCLEOD PRIMARY CARE CLARENDON
  • Facility Address: 50 EAST HOSPITAL STREET SUITE 3
    MANNING, SC
    ZIP 29102
  • Facility Phone: 803 435-8828
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. LISA E. HEICHBERGER
  • NPI Number: 1083067714
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 42D0683879
LAB Type Physician Office
Facility Name MCLEOD PRIMARY CARE CLARENDON
Street 50 EAST HOSPITAL STREET SUITE 3
City MANNING
State SC
ZIP 29102
Phone 803 435-8828
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 9/10/2025
Certificate Expiration Date 9/9/2027
Facility Type Physician Office
Lab Director DR. LISA E. HEICHBERGER

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