42D0694880 CLIA NUMBER - FAMILY MEDICINE CENTER

Laboratory Demographics

  • CLIA Code: 42D0694880
  • Facility Name: FAMILY MEDICINE CENTER
  • Facility Address: 109 DUKES STREET
    ST GEORGE, SC
    ZIP 29477
  • Facility Phone: 803 563-2484
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: C B. JORDAN
  • NPI Number: 1215110697
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 42D0694880
LAB Type Physician Office
Facility Name FAMILY MEDICINE CENTER
Street 109 DUKES STREET
City ST GEORGE
State SC
ZIP 29477
Phone 803 563-2484
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 5/18/2024
Certificate Expiration Date 5/17/2026
Facility Type Physician Office
Lab Director C B. JORDAN

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