42D0934934 CLIA NUMBER - INTERNAL MEDICINE AND CARDIOLOGY CTR

Laboratory Demographics

  • CLIA Code: 42D0934934
  • Facility Name: INTERNAL MEDICINE AND CARDIOLOGY CTR
  • Facility Address: 401 GUESS ST
    GREENVILLE, SC
    ZIP 29605
  • Facility Phone: 864 233-2744
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: VINITA SRIVASTAVA M D
  • NPI Number: 1578650792
  • Taxonomy: 261QM2500X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 42D0934934
LAB Type Physician Office
Facility Name INTERNAL MEDICINE AND CARDIOLOGY CTR
Street 401 GUESS ST
City GREENVILLE
State SC
ZIP 29605
Phone 864 233-2744
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/10/2024
Certificate Expiration Date 2/9/2026
Facility Type Physician Office
Lab Director VINITA SRIVASTAVA M D

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This page was last updated on: 6/4/2025