42D0961258 CLIA NUMBER - SEA ISLAND MEDICAL PRACTICE

Laboratory Demographics

  • CLIA Code: 42D0961258
  • Facility Name: SEA ISLAND MEDICAL PRACTICE
  • Facility Address: 12 PROFESSIONAL VILLAGE CIRCLE
    BEAUFORT, SC
    ZIP 29907
  • Facility Phone: 843 524-6829
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: IRINA BORISSOVA MD
  • NPI Number: 1871822957
  • Taxonomy: 1223G0001X - Dentist

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 42D0961258
LAB Type Physician Office
Facility Name SEA ISLAND MEDICAL PRACTICE
Street 12 PROFESSIONAL VILLAGE CIRCLE
City BEAUFORT
State SC
ZIP 29907
Phone 843 524-6829
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 10/2/2023
Certificate Expiration Date 10/1/2025
Facility Type Physician Office
Lab Director IRINA BORISSOVA MD

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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