42D1001875 CLIA NUMBER - PRESBYTERIAN HOME OF SC SUMMERVILLE

Laboratory Demographics

  • CLIA Code: 42D1001875
  • Facility Name: PRESBYTERIAN HOME OF SC SUMMERVILLE
  • Facility Address: 201 W 9TH NORTH STREET
    SUMMERVILLE, SC
    ZIP 29483
  • Facility Phone: 843 873-2550
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: MARY GUILLAUME
  • NPI Number: 1396940649
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 42D1001875
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name PRESBYTERIAN HOME OF SC SUMMERVILLE
Street 201 W 9TH NORTH STREET
City SUMMERVILLE
State SC
ZIP 29483
Phone 843 873-2550
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/23/2024
Certificate Expiration Date 7/22/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director MARY GUILLAUME

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This page was last updated on: 3/20/2025