42D0909073 CLIA NUMBER - GOLDEN AGE - INMAN, INC

Laboratory Demographics

  • CLIA Code: 42D0909073
  • Facility Name: GOLDEN AGE - INMAN, INC
  • Facility Address: 82 NORTH MAIN STREET
    INMAN, SC
    ZIP 29349
  • Facility Phone: 864 472-6636
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: TIMOTHY JOHNSON
  • NPI Number: 1083043780
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 42D0909073
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name GOLDEN AGE - INMAN, INC
Street 82 NORTH MAIN STREET
City INMAN
State SC
ZIP 29349
Phone 864 472-6636
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/22/2023
Certificate Expiration Date 11/21/2025
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director TIMOTHY JOHNSON

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