42D0857377 CLIA NUMBER - JOLLEY ACRES HEALTHCARE CENTER

Laboratory Demographics

  • CLIA Code: 42D0857377
  • Facility Name: JOLLEY ACRES HEALTHCARE CENTER
  • Facility Address: 1180 WOLFE TRAIL
    ORANGEBURG, SC
    ZIP 29115
  • Facility Phone: 803 534-1001
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: VANN B. SHULER
  • NPI Number: 1093897639
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 42D0857377
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name JOLLEY ACRES HEALTHCARE CENTER
Street 1180 WOLFE TRAIL
City ORANGEBURG
State SC
ZIP 29115
Phone 803 534-1001
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director VANN B. SHULER

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