42D0986094 CLIA NUMBER - MACKEY FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 42D0986094
  • Facility Name: MACKEY FAMILY PRACTICE
  • Facility Address: 8351 CHARLOTTE HIGHWAY
    INDIAN LAND, SC
    ZIP 29707
  • Facility Phone: 803 548-4114
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KEITH D. SHEALY
  • NPI Number: 1700160157
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 42D0986094
LAB Type Physician Office
Facility Name MACKEY FAMILY PRACTICE
Street 8351 CHARLOTTE HIGHWAY
City INDIAN LAND
State SC
ZIP 29707
Phone 803 548-4114
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/25/2025
Certificate Expiration Date 4/24/2027
Facility Type Physician Office
Lab Director KEITH D. SHEALY

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