42D1020363 CLIA NUMBER - EAST COOPER COASTAL FAMILY PHYSICIANS DBA COASTAL FAMILY PHYSICIANS AT PARK WEST

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Laboratory Demographics

CLIA Number: 42D1020363

Facility Name: EAST COOPER COASTAL FAMILY PHYSICIANS DBA COASTAL FAMILY PHYSICIANS AT PARK WEST

Facility Address:
3400 SALTERBECK, SUITE 100A
MOUNT PLEASANT, SC
ZIP 29466
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Facility Phone Number: 843 606-9474

Facility Type: Other

Certificate Type: Microscopy

NPI Number: 1992932271

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	42D1020363
LAB Type	Other
Facility Name	EAST COOPER COASTAL FAMILY PHYSICIANS DBA COASTAL FAMILY PHYSICIANS AT PARK WEST
Street	3400 SALTERBECK, SUITE 100A
City	MOUNT PLEASANT
State	SC
ZIP	29466
Phone	843 606-9474
CertificateType	3
CertificateEffectiveDate	12/17/2023
CertificateExpirationDate	12/16/2025
FacilityType	PPMP

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