42D0883465 CLIA NUMBER - MCLEOD PEDIATRICS - DILLON

Laboratory Demographics

  • CLIA Code: 42D0883465
  • Facility Name: MCLEOD PEDIATRICS - DILLON
  • Facility Address: 705 N 8TH AVE SUITE 3A
    DILLON, SC
    ZIP 29536
  • Facility Phone: 843 774-6091
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: DR. JOSEPH WANGEH
  • NPI Number: 1902879497
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 42D0883465
LAB Type Rural Health Clinic
Facility Name MCLEOD PEDIATRICS - DILLON
Street 705 N 8TH AVE SUITE 3A
City DILLON
State SC
ZIP 29536
Phone 843 774-6091
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/16/2024
Certificate Expiration Date 9/15/2026
Facility Type Rural Health Clinic
Lab Director DR. JOSEPH WANGEH

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