42D1031627 CLIA NUMBER - CAROLINA PEDIATRIC ASSOCIATES

Laboratory Demographics

CLIA Number: 42D1031627

Facility Name: CAROLINA PEDIATRIC ASSOCIATES

Facility Address:
1610-B N LIMESTONE ST
GAFFNEY, SC
ZIP 29340
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Facility Phone Number: 864 839-4325

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1992840375

Taxonomy: 261QM0801X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	42D1031627
LAB Type	Physician Office
Facility Name	CAROLINA PEDIATRIC ASSOCIATES
Street	1610-B N LIMESTONE ST
City	GAFFNEY
State	SC
ZIP	29340
Phone	864 839-4325
CertificateType	4
CertificateEffectiveDate	10/5/2022
CertificateExpirationDate	10/4/2024
FacilityType	Waiver

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