42D1028888 CLIA NUMBER - BABCOCK CENTER INC

Laboratory Demographics

CLIA Code: 42D1028888
Facility Name: BABCOCK CENTER INC
Facility Address: 2725 BANNY JONES AVE
WEST COLUMBIA, SC
ZIP 29170
Facility Phone: 803 799-1970
Facility Type: Intermediate Care Facility for Mentally Retarded
Facility Type: Waiver
Lab Director: BRYAN SIMMONS
NPI Number: 1831463538
Taxonomy: 320600000X - Residential Treatment Facility, Intellectual and/or Developmental Disabilities

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CLIA Record

Field Name	Field Value
CLIA Number	42D1028888
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	BABCOCK CENTER INC
Street	2725 BANNY JONES AVE
City	WEST COLUMBIA
State	SC
ZIP	29170
Phone	803 799-1970
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	8/4/2024
Certificate Expiration Date	8/3/2026
Facility Type	Intermediate Care Facility for Mentally Retarded
Lab Director	BRYAN SIMMONS

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