42D0965858 CLIA NUMBER - CMC PRIMARY CARE - CONWAY

Laboratory Demographics

  • CLIA Code: 42D0965858
  • Facility Name: CMC PRIMARY CARE - CONWAY
  • Facility Address: 2367-B CYPRESS CIRCLE
    CONWAY, SC
    ZIP 29526
  • Facility Phone: 843 349-1001
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PAUL M. RICHARDSON MD
  • NPI Number: 1043809569
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 42D0965858
LAB Type Physician Office
Facility Name CMC PRIMARY CARE - CONWAY
Street 2367-B CYPRESS CIRCLE
City CONWAY
State SC
ZIP 29526
Phone 843 349-1001
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/30/2025
Certificate Expiration Date 9/29/2027
Facility Type Physician Office
Lab Director PAUL M. RICHARDSON MD

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