42D1039800 CLIA NUMBER - PLASTIC SURGERY CONSULTANTS LLC

Laboratory Demographics

  • CLIA Code: 42D1039800
  • Facility Name: PLASTIC SURGERY CONSULTANTS LLC
  • Facility Address: 1220 BLANDING ST
    COLUMBIA, SC
    ZIP 29201
  • Facility Phone: 803 779-1200
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: RICHARD J. WASSERMAN MD
  • NPI Number: 1245319094
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 42D1039800
LAB Type Other
Facility Name PLASTIC SURGERY CONSULTANTS LLC
Street 1220 BLANDING ST
City COLUMBIA
State SC
ZIP 29201
Phone 803 779-1200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/8/2024
Certificate Expiration Date 4/7/2026
Facility Type Other
Lab Director RICHARD J. WASSERMAN MD

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