42D0969655 CLIA NUMBER - PALMETTO SURGERY CENTER

Laboratory Demographics

CLIA Number: 42D0969655

Facility Name: PALMETTO SURGERY CENTER

Facility Address:
109 BLARNEY DRIVE
COLUMBIA, SC
ZIP 29223
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Facility Phone Number: 803 865-8200

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1073505038

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	42D0969655
LAB Type	Ambulatory Surgery Center
Facility Name	PALMETTO SURGERY CENTER
Street	109 BLARNEY DRIVE
City	COLUMBIA
State	SC
ZIP	29223
Phone	803 865-8200
CertificateType	4
CertificateEffectiveDate	5/2/2023
CertificateExpirationDate	5/1/2025
FacilityType	Waiver

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