42D0940858 CLIA NUMBER - RIVERTOWN FAMILY MEDICINE PC

Laboratory Demographics

  • CLIA Code: 42D0940858
  • Facility Name: RIVERTOWN FAMILY MEDICINE PC
  • Facility Address: 1210 MAIN STREET
    CONWAY, SC
    ZIP 29526
  • Facility Phone: 843 488-1700
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: BRITTANY Z. GUSIN
  • NPI Number: 1447637327
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 42D0940858
LAB Type Physician Office
Facility Name RIVERTOWN FAMILY MEDICINE PC
Street 1210 MAIN STREET
City CONWAY
State SC
ZIP 29526
Phone 843 488-1700
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 5/8/2025
Certificate Expiration Date 5/7/2027
Facility Type Physician Office
Lab Director BRITTANY Z. GUSIN

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