42D0967754 CLIA NUMBER - FLORENCE COUNTY DSN BOARD

Laboratory Demographics

  • CLIA Code: 42D0967754
  • Facility Name: FLORENCE COUNTY DSN BOARD
  • Facility Address: 1211 NATIONAL CEMETERY RD ATTN BETH BARR
    FLORENCE, SC
    ZIP 29506
  • Facility Phone: 843 667-5007
  • Facility Type: Intermediate Care Facility for Mentally Retarded
  • Facility Type: Waiver
  • Lab Director: VICKI LEEKE
  • NPI Number: 1306801840
  • Taxonomy: 207T00000X - Neurological Surgery

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CLIA Record

Field Name Field Value
CLIA Number 42D0967754
LAB Type Intermediate Care Facility for Mentally Retarded
Facility Name FLORENCE COUNTY DSN BOARD
Street 1211 NATIONAL CEMETERY RD ATTN BETH BARR
City FLORENCE
State SC
ZIP 29506
Phone 843 667-5007
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/22/2023
Certificate Expiration Date 11/21/2025
Facility Type Intermediate Care Facility for Mentally Retarded
Lab Director VICKI LEEKE

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