42D1035810 CLIA NUMBER - SELF MEDICAL GROUP ORTHOPAEDIC ASSOCIATES OF THE LAKELANDS

Laboratory Demographics

  • CLIA Code: 42D1035810
  • Facility Name: SELF MEDICAL GROUP ORTHOPAEDIC ASSOCIATES OF THE LAKELANDS
  • Facility Address: 102 GREGOR MENDEL CIRCLE
    GREENWOOD, SC
    ZIP 29646
  • Facility Phone: 864 229-2663
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RICHARD CHRISTIAN
  • NPI Number: 1902277270
  • Taxonomy: 207T00000X - Neurological Surgery

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CLIA Record

Field Name Field Value
CLIA Number 42D1035810
LAB Type Physician Office
Facility Name SELF MEDICAL GROUP ORTHOPAEDIC ASSOCIATES OF THE LAKELANDS
Street 102 GREGOR MENDEL CIRCLE
City GREENWOOD
State SC
ZIP 29646
Phone 864 229-2663
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/11/2025
Certificate Expiration Date 1/10/2027
Facility Type Physician Office
Lab Director RICHARD CHRISTIAN

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