42D1020416 CLIA NUMBER - WACCAMAW DERMATOLOGY, LLC

Laboratory Demographics

  • CLIA Code: 42D1020416
  • Facility Name: WACCAMAW DERMATOLOGY, LLC
  • Facility Address: 14880 OCEAN HIGHWAY
    PAWLEYS ISLAND, SC
    ZIP 29585
  • Facility Phone: 843 497-8932
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: BRANDON J. COAKLEY
  • NPI Number: 1497062384
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 42D1020416
LAB Type Physician Office
Facility Name WACCAMAW DERMATOLOGY, LLC
Street 14880 OCEAN HIGHWAY
City PAWLEYS ISLAND
State SC
ZIP 29585
Phone 843 497-8932
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 9/18/2023
Certificate Expiration Date 10/31/2025
Facility Type Physician Office
Lab Director BRANDON J. COAKLEY

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