42D1014683 CLIA NUMBER - UNION CO COMMISSION ON ALCOHOL & DRUG ABUSE

Laboratory Demographics

CLIA Number: 42D1014683

Facility Name: UNION CO COMMISSION ON ALCOHOL & DRUG ABUSE

Facility Address:
201 SOUTH HERNDON ST
UNION, SC
ZIP 29379
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Facility Phone Number: 864 429-1656

Facility Type: Comp. Outpatient Rehab Facility

Certificate Type: Waiver

NPI Number: 1720052723

Taxonomy: 3416L0300X - Ambulance

CLIA Record

Field Name	Field Value
CLIA Number	42D1014683
LAB Type	Comp. Outpatient Rehab Facility
Facility Name	UNION CO COMMISSION ON ALCOHOL & DRUG ABUSE
Street	201 SOUTH HERNDON ST
City	UNION
State	SC
ZIP	29379
Phone	864 429-1656
CertificateType	4
CertificateEffectiveDate	7/15/2023
CertificateExpirationDate	7/14/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024