42D0995117 CLIA NUMBER - MCCORMICK FAMILY PRACTICE CENTER

Laboratory Demographics

  • CLIA Code: 42D0995117
  • Facility Name: MCCORMICK FAMILY PRACTICE CENTER
  • Facility Address: 1319 S MAIN STREET
    MC CORMICK, SC
    ZIP 29835
  • Facility Phone: 864 852-3336
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: LOCKE SIMONS
  • NPI Number: 1992798250
  • Taxonomy: 341600000X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 42D0995117
LAB Type Rural Health Clinic
Facility Name MCCORMICK FAMILY PRACTICE CENTER
Street 1319 S MAIN STREET
City MC CORMICK
State SC
ZIP 29835
Phone 864 852-3336
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/22/2025
Certificate Expiration Date 6/21/2027
Facility Type Rural Health Clinic
Lab Director LOCKE SIMONS

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