42D0914602 CLIA NUMBER - DIALYSIS CLINIC, INC - WEST ATTN PENNY GLOVER

Laboratory Demographics

  • CLIA Code: 42D0914602
  • Facility Name: DIALYSIS CLINIC, INC - WEST ATTN PENNY GLOVER
  • Facility Address: 105 TRADD STREET
    SPARTANBURG, SC
    ZIP 29301
  • Facility Phone: 864 574-8828
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: STEPHEN L. GARRELL M D
  • NPI Number: 1699708073
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 42D0914602
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name DIALYSIS CLINIC, INC - WEST ATTN PENNY GLOVER
Street 105 TRADD STREET
City SPARTANBURG
State SC
ZIP 29301
Phone 864 574-8828
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/6/2024
Certificate Expiration Date 5/5/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director STEPHEN L. GARRELL M D

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