42D0967663 CLIA NUMBER - UPSTATE OCCUPATIONAL MEDICINE/WELLNESS

Laboratory Demographics

CLIA Number: 42D0967663

Facility Name: UPSTATE OCCUPATIONAL MEDICINE/WELLNESS

Facility Address:
1241 BOILING SPRINGS ROAD
SPARTANBURG, SC
ZIP 29303
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Facility Phone Number: 864 591-0992

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1063445971

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	42D0967663
LAB Type	Physician Office
Facility Name	UPSTATE OCCUPATIONAL MEDICINE/WELLNESS
Street	1241 BOILING SPRINGS ROAD
City	SPARTANBURG
State	SC
ZIP	29303
Phone	864 591-0992
CertificateType	4
CertificateEffectiveDate	11/19/2023
CertificateExpirationDate	11/18/2025
FacilityType	Waiver

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