42D0924458 CLIA NUMBER - HILLCREST DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 42D0924458
  • Facility Name: HILLCREST DERMATOLOGY
  • Facility Address: 1719 VILLAGEPARK
    ORANGEBURG, SC
    ZIP 29118
  • Facility Phone: 803 535-0909
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: GREGG J. COLLE M D
  • NPI Number: 1023216033
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 42D0924458
LAB Type Physician Office
Facility Name HILLCREST DERMATOLOGY
Street 1719 VILLAGEPARK
City ORANGEBURG
State SC
ZIP 29118
Phone 803 535-0909
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 4/4/2025
Certificate Expiration Date 4/3/2027
Facility Type Physician Office
Lab Director GREGG J. COLLE M D

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