42D0967382 CLIA NUMBER - PRIMARY CHOICE MEDICAL

Laboratory Demographics

  • CLIA Code: 42D0967382
  • Facility Name: PRIMARY CHOICE MEDICAL
  • Facility Address: 23 BUENA VISTA WAY, STE A
    GREENVILLE, SC
    ZIP 29615
  • Facility Phone: 864 312-3388
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. RONALD S. PHILLIPS
  • NPI Number: 1891078606
  • Taxonomy: 207R00000X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 42D0967382
LAB Type Physician Office
Facility Name PRIMARY CHOICE MEDICAL
Street 23 BUENA VISTA WAY, STE A
City GREENVILLE
State SC
ZIP 29615
Phone 864 312-3388
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/20/2025
Certificate Expiration Date 6/19/2027
Facility Type Physician Office
Lab Director DR. RONALD S. PHILLIPS

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