42D0962420 CLIA NUMBER - MUSC HEALTH HEART & VASCULAR HAILE ST

Laboratory Demographics

CLIA Number: 42D0962420

Facility Name: MUSC HEALTH HEART & VASCULAR HAILE ST

Facility Address:
1330 HAILE STREET
CAMDEN, SC
ZIP 29020
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Facility Phone Number: 803 432-6771

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1306416680

Taxonomy: 283Q00000X - Psychiatric Hospital
An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings.

CLIA Record

Field Name	Field Value
CLIA Number	42D0962420
LAB Type	Physician Office
Facility Name	MUSC HEALTH HEART & VASCULAR HAILE ST
Street	1330 HAILE STREET
City	CAMDEN
State	SC
ZIP	29020
Phone	803 432-6771
CertificateType	4
CertificateEffectiveDate	7/2/2023
CertificateExpirationDate	7/1/2025
FacilityType	Waiver

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