42D0690142 CLIA NUMBER - JOSE J CHAVEZ MD

Laboratory Demographics

  • CLIA Code: 42D0690142
  • Facility Name: JOSE J CHAVEZ MD
  • Facility Address: 17 SURREY COURT
    COLUMBIA, SC
    ZIP 29212
  • Facility Phone: 803 772-4172
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOSE J. CHAVEZ MD
  • NPI Number: 1194779900
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 42D0690142
LAB Type Physician Office
Facility Name JOSE J CHAVEZ MD
Street 17 SURREY COURT
City COLUMBIA
State SC
ZIP 29212
Phone 803 772-4172
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/24/2024
Certificate Expiration Date 1/23/2026
Facility Type Physician Office
Lab Director JOSE J. CHAVEZ MD

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