42D0884050 CLIA NUMBER - JAMES ISLAND INTERNAL MEDICINE-CFC INC

Laboratory Demographics

  • CLIA Code: 42D0884050
  • Facility Name: JAMES ISLAND INTERNAL MEDICINE-CFC INC
  • Facility Address: 490 MARTELLO DRIVE
    CHARLESTON, SC
    ZIP 29412
  • Facility Phone: 843 762-5480
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. KATHY SIEGFRIED BOLUS
  • NPI Number: 1316051345
  • Taxonomy: 207Q00000X - Family Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 42D0884050
LAB Type Physician Office
Facility Name JAMES ISLAND INTERNAL MEDICINE-CFC INC
Street 490 MARTELLO DRIVE
City CHARLESTON
State SC
ZIP 29412
Phone 843 762-5480
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/3/2025
Certificate Expiration Date 6/2/2027
Facility Type Physician Office
Lab Director DR. KATHY SIEGFRIED BOLUS

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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