42D0981664 CLIA NUMBER - ACTIVE DAY OF LOWCOUNTRY

Laboratory Demographics

  • CLIA Code: 42D0981664
  • Facility Name: ACTIVE DAY OF LOWCOUNTRY
  • Facility Address: 104 SPRING HALL DRIVE
    GOOSE CREEK, SC
    ZIP 29445
  • Facility Phone: 843 797-3134
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: EBONY MUNGIN
  • NPI Number: 1215077540
  • Taxonomy: 261QA0600X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 42D0981664
LAB Type Other
Facility Name ACTIVE DAY OF LOWCOUNTRY
Street 104 SPRING HALL DRIVE
City GOOSE CREEK
State SC
ZIP 29445
Phone 843 797-3134
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/3/2025
Certificate Expiration Date 1/2/2027
Facility Type Other
Lab Director EBONY MUNGIN

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