42D0986188 CLIA NUMBER - PINEWOOD PLACE

Laboratory Demographics

  • CLIA Code: 42D0986188
  • Facility Name: PINEWOOD PLACE
  • Facility Address: 101 CENTENNIAL BOULEVARD
    GOOSE CREEK, SC
    ZIP 29445
  • Facility Phone: 843 569-2520
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: STEPHANIE KELLEHER
  • NPI Number: 1003003393
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 42D0986188
LAB Type Assisted Living Facility
Facility Name PINEWOOD PLACE
Street 101 CENTENNIAL BOULEVARD
City GOOSE CREEK
State SC
ZIP 29445
Phone 843 569-2520
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/9/2025
Certificate Expiration Date 5/8/2027
Facility Type Assisted Living Facility
Lab Director STEPHANIE KELLEHER

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