42D0996263 CLIA NUMBER - AMBULATORY SURGERY CTR SPARTANBURG LLC

Laboratory Demographics

  • CLIA Code: 42D0996263
  • Facility Name: AMBULATORY SURGERY CTR SPARTANBURG LLC
  • Facility Address: 720 NORTH PINE STREET
    SPARTANBURG, SC
    ZIP 29303
  • Facility Phone: 864 560-6556
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: JOHN D. WREN
  • NPI Number: 1386695351
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 42D0996263
LAB Type Ambulatory Surgery Center
Facility Name AMBULATORY SURGERY CTR SPARTANBURG LLC
Street 720 NORTH PINE STREET
City SPARTANBURG
State SC
ZIP 29303
Phone 864 560-6556
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/13/2024
Certificate Expiration Date 2/12/2026
Facility Type Ambulatory Surgery Center
Lab Director JOHN D. WREN

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