42D0861933 CLIA NUMBER - ST GEORGE FAMILY HEALTH CENTER

Laboratory Demographics

  • CLIA Code: 42D0861933
  • Facility Name: ST GEORGE FAMILY HEALTH CENTER
  • Facility Address: 401 RIDGE STREET
    SAINT GEORGE, SC
    ZIP 29477
  • Facility Phone: 803 563-5315
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. SANDRA STEPHENS
  • NPI Number: 1235665928
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 42D0861933
LAB Type Physician Office
Facility Name ST GEORGE FAMILY HEALTH CENTER
Street 401 RIDGE STREET
City SAINT GEORGE
State SC
ZIP 29477
Phone 803 563-5315
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 10/28/2023
Certificate Expiration Date 10/27/2025
Facility Type Physician Office
Lab Director DR. SANDRA STEPHENS

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