42D0950983 CLIA NUMBER - INTERNAL MEDICINE LAURENS A DIVISION OF SELF MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 42D0950983
  • Facility Name: INTERNAL MEDICINE LAURENS A DIVISION OF SELF MEDICAL GROUP
  • Facility Address: 22580 HWY 76 EAST SUITE 200
    LAURENS, SC
    ZIP 29360
  • Facility Phone: 864 833-0055
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: BRIAN WEIRICK
  • NPI Number: 1104137892
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 42D0950983
LAB Type Physician Office
Facility Name INTERNAL MEDICINE LAURENS A DIVISION OF SELF MEDICAL GROUP
Street 22580 HWY 76 EAST SUITE 200
City LAURENS
State SC
ZIP 29360
Phone 864 833-0055
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 9/10/2024
Certificate Expiration Date 9/9/2026
Facility Type Physician Office
Lab Director BRIAN WEIRICK

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