42D0960423 CLIA NUMBER - NATIONAL ALLERGY AND ASTHMA

Laboratory Demographics

CLIA Number: 42D0960423

Facility Name: NATIONAL ALLERGY AND ASTHMA

Facility Address:
1470 TOBIAS GADSON BLVD, STE 204
CHARLESTON, SC
ZIP 29407
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Facility Phone Number: 843 852-2205

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1114012945

Taxonomy: 207KA0200X - Allergy & Immunology
A physician who specializes in the diagnosis, treatment, and management of allergies. Source: National Uniform Claim Committee

CLIA Record

Field Name	Field Value
CLIA Number	42D0960423
LAB Type	Physician Office
Facility Name	NATIONAL ALLERGY AND ASTHMA
Street	1470 TOBIAS GADSON BLVD, STE 204
City	CHARLESTON
State	SC
ZIP	29407
Phone	843 852-2205
CertificateType	4
CertificateEffectiveDate	6/1/2023
CertificateExpirationDate	5/31/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024