42D0985320 CLIA NUMBER - PALMETTO PRIMARY CARE PHYSICIANS ARCHDALE

Laboratory Demographics

  • CLIA Code: 42D0985320
  • Facility Name: PALMETTO PRIMARY CARE PHYSICIANS ARCHDALE
  • Facility Address: 5325 APPIAN WAY
    CHARLESTON, SC
    ZIP 29420
  • Facility Phone: 843 552-0400
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: J MARK REDWINE, MD
  • NPI Number: 1285673269
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 42D0985320
LAB Type Physician Office
Facility Name PALMETTO PRIMARY CARE PHYSICIANS ARCHDALE
Street 5325 APPIAN WAY
City CHARLESTON
State SC
ZIP 29420
Phone 843 552-0400
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 4/13/2025
Certificate Expiration Date 4/12/2027
Facility Type Physician Office
Lab Director J MARK REDWINE, MD

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