42D0926543 CLIA NUMBER - BROAD CREEK CARE CENTER AT TIDEPOINTE

Laboratory Demographics

  • CLIA Code: 42D0926543
  • Facility Name: BROAD CREEK CARE CENTER AT TIDEPOINTE
  • Facility Address: 801 LEMON GRASS COURT
    HILTON HEAD ISLAND, SC
    ZIP 29928
  • Facility Phone: 843 341-7300
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: WILLIAM FRAZIER JACKSON
  • NPI Number: 1578553871
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 42D0926543
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name BROAD CREEK CARE CENTER AT TIDEPOINTE
Street 801 LEMON GRASS COURT
City HILTON HEAD ISLAND
State SC
ZIP 29928
Phone 843 341-7300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/25/2025
Certificate Expiration Date 3/24/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director WILLIAM FRAZIER JACKSON

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