42D0720944 CLIA NUMBER - SC STATE UNIVERSITY-BROOKS HEALTH CENTER

Laboratory Demographics

  • CLIA Code: 42D0720944
  • Facility Name: SC STATE UNIVERSITY-BROOKS HEALTH CENTER
  • Facility Address: 300 COLLEGE STREET NE PO BOX 7178
    ORANGEBURG, SC
    ZIP 29117
  • Facility Phone: 803 536-7053
  • Facility Type: School/Student Health Service
  • Facility Type: Microscopy
  • Lab Director: DR. EMILY KRODEL
  • NPI Number: 1033288402
  • Taxonomy: 235Z00000X - Speech-Language Pathologist

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CLIA Record

Field Name Field Value
CLIA Number 42D0720944
LAB Type School/Student Health Service
Facility Name SC STATE UNIVERSITY-BROOKS HEALTH CENTER
Street 300 COLLEGE STREET NE PO BOX 7178
City ORANGEBURG
State SC
ZIP 29117
Phone 803 536-7053
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 School/Student Health Service
Lab Director DR. EMILY KRODEL

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This page was last updated on: 6/4/2025