42D0882557 CLIA NUMBER - PRUITTHEALTH - RIDGEWAY, LLC

Laboratory Demographics

  • CLIA Code: 42D0882557
  • Facility Name: PRUITTHEALTH - RIDGEWAY, LLC
  • Facility Address: 231 TANGLEWOOD COURT
    RIDGEWAY, SC
    ZIP 29130
  • Facility Phone: 803 337-3211
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: KAREN PHILLIPS
  • NPI Number: 1104865138
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 42D0882557
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name PRUITTHEALTH - RIDGEWAY, LLC
Street 231 TANGLEWOOD COURT
City RIDGEWAY
State SC
ZIP 29130
Phone 803 337-3211
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/21/2025
Certificate Expiration Date 5/20/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director KAREN PHILLIPS

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