42D0883226 CLIA NUMBER - UPSTATE SURGERY CENTER LLC

Laboratory Demographics

CLIA Number: 42D0883226

Facility Name: UPSTATE SURGERY CENTER LLC

Facility Address:
10 ENTERPRISE BLVD STE 104
GREENVILLE, SC
ZIP 29615
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Facility Phone Number: 864 255-1598

Facility Type: Ambulatory Surgery Center

Certificate Type: Accreditation

NPI Number: 1619998523

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	42D0883226
LAB Type	Ambulatory Surgery Center
Facility Name	UPSTATE SURGERY CENTER LLC
Street	10 ENTERPRISE BLVD STE 104
City	GREENVILLE
State	SC
ZIP	29615
Phone	864 255-1598
CertificateType	1
CertificateEffectiveDate	4/28/2023
CertificateExpirationDate	4/27/2025
FacilityType	Accreditation

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This page was last updated on: 4/23/2024