42D1013960 CLIA NUMBER - BERKELEY CITIZENS INC

Laboratory Demographics

  • CLIA Code: 42D1013960
  • Facility Name: BERKELEY CITIZENS INC
  • Facility Address: 1301 OLD HIGHWAY 52 SOUTH
    MONCKS CORNER, SC
    ZIP 29461
  • Facility Phone: 843 761-0311
  • Facility Type: Intermediate Care Facility for Mentally Retarded
  • Facility Type: Waiver
  • Lab Director: ALICE E. SHOOK
  • NPI Number: 1962420927
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 42D1013960
LAB Type Intermediate Care Facility for Mentally Retarded
Facility Name BERKELEY CITIZENS INC
Street 1301 OLD HIGHWAY 52 SOUTH
City MONCKS CORNER
State SC
ZIP 29461
Phone 843 761-0311
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/23/2025
Certificate Expiration Date 6/22/2027
Facility Type Intermediate Care Facility for Mentally Retarded
Lab Director ALICE E. SHOOK

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