42D0989215 CLIA NUMBER - QUILLEN MANOR LLC

Laboratory Demographics

  • CLIA Code: 42D0989215
  • Facility Name: QUILLEN MANOR LLC
  • Facility Address: 709 QUILLEN AVENUE
    FOUNTAIN INN, SC
    ZIP 29644
  • Facility Phone: 864 862-3252
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: CAROLYN GILSTRAP HANKS
  • NPI Number: 1255655650
  • Taxonomy: 310400000X - Assisted Living Facility

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 42D0989215
LAB Type Other
Facility Name QUILLEN MANOR LLC
Street 709 QUILLEN AVENUE
City FOUNTAIN INN
State SC
ZIP 29644
Phone 864 862-3252
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/28/2025
Certificate Expiration Date 7/27/2027
Facility Type Other
Lab Director CAROLYN GILSTRAP HANKS

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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