42D0963043 CLIA NUMBER - ANMED PRIMARY CARE - LAKESIDE

Laboratory Demographics

  • CLIA Code: 42D0963043
  • Facility Name: ANMED PRIMARY CARE - LAKESIDE
  • Facility Address: 4120 HIGHWAY 24
    ANDERSON, SC
    ZIP 29626
  • Facility Phone: 864 512-5830
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JUSTIN MOORE
  • NPI Number: 1023318383
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 42D0963043
LAB Type Physician Office
Facility Name ANMED PRIMARY CARE - LAKESIDE
Street 4120 HIGHWAY 24
City ANDERSON
State SC
ZIP 29626
Phone 864 512-5830
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 7/21/2025
Certificate Expiration Date 7/20/2027
Facility Type Physician Office
Lab Director JUSTIN MOORE

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