42D0926195 CLIA NUMBER - CMC STUDENT HEALTH COASTAL CAROLINA UNIVERSITY

Laboratory Demographics

CLIA Code: 42D0926195
Facility Name: CMC STUDENT HEALTH COASTAL CAROLINA UNIVERSITY
Facility Address: 251 UNIVERSITY BOULEVARD SUITE B
CONWAY, SC
ZIP 29526
Facility Phone: 843 347-1012
Facility Type: School/Student Health Service
Facility Type: Microscopy
Lab Director: MARIE P. LIVIGNI
NPI Number: 1366285207
Taxonomy: 207R00000X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name	Field Value
CLIA Number	42D0926195
LAB Type	School/Student Health Service
Facility Name	CMC STUDENT HEALTH COASTAL CAROLINA UNIVERSITY
Street	251 UNIVERSITY BOULEVARD SUITE B
City	CONWAY
State	SC
ZIP	29526
Phone	843 347-1012
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	9/13/2025
Certificate Expiration Date	9/12/2027
Facility Type	School/Student Health Service
Lab Director	MARIE P. LIVIGNI

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