42D1014412 CLIA NUMBER - PHOENIX CENTER,THE

Laboratory Demographics

  • CLIA Code: 42D1014412
  • Facility Name: PHOENIX CENTER,THE
  • Facility Address: 1400 CLEVELAND STREET
    GREENVILLE, SC
    ZIP 29607
  • Facility Phone: 864 467-3790
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: REBECCA L. MADDOX
  • NPI Number: 1861892259
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 42D1014412
LAB Type Comp. Outpatient Rehab Facility
Facility Name PHOENIX CENTER,THE
Street 1400 CLEVELAND STREET
City GREENVILLE
State SC
ZIP 29607
Phone 864 467-3790
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/4/2025
Certificate Expiration Date 4/3/2027
Facility Type Comp. Outpatient Rehab Facility
Lab Director REBECCA L. MADDOX

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