42D0945614 CLIA NUMBER - MAGNOLIA PEDIATRICS

Laboratory Demographics

  • CLIA Code: 42D0945614
  • Facility Name: MAGNOLIA PEDIATRICS
  • Facility Address: 600 SINGLETON RIDGE ROAD
    CONWAY, SC
    ZIP 29526
  • Facility Phone: 843 347-9099
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: STEPHEN A. CORONTZES
  • NPI Number: 1467618298
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 42D0945614
LAB Type Physician Office
Facility Name MAGNOLIA PEDIATRICS
Street 600 SINGLETON RIDGE ROAD
City CONWAY
State SC
ZIP 29526
Phone 843 347-9099
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/24/2025
Certificate Expiration Date 9/23/2027
Facility Type Physician Office
Lab Director STEPHEN A. CORONTZES

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