42D0913726 CLIA NUMBER - SAGEBRUSH HEALTH

Laboratory Demographics

CLIA Number: 42D0913726

Facility Name: SAGEBRUSH HEALTH

Facility Address:
1768 VILLAGEPARK DRIVE
ORANGEBURG, SC
ZIP 29118
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Facility Phone Number: 803 539-2224

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1245625086

Taxonomy: 207RR0500X - Internal Medicine
An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and collagen diseases.

CLIA Record

Field Name	Field Value
CLIA Number	42D0913726
LAB Type	Physician Office
Facility Name	SAGEBRUSH HEALTH
Street	1768 VILLAGEPARK DRIVE
City	ORANGEBURG
State	SC
ZIP	29118
Phone	803 539-2224
CertificateType	4
CertificateEffectiveDate	11/8/2022
CertificateExpirationDate	11/7/2024
FacilityType	Waiver

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