42D1040638 CLIA NUMBER - WILLIE B LOUIS MD PA

Laboratory Demographics

  • CLIA Code: 42D1040638
  • Facility Name: WILLIE B LOUIS MD PA
  • Facility Address: 1102 SUMMERS AVENUE
    ORANGEBURG, SC
    ZIP 29115
  • Facility Phone: 803 534-2270
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: WILLIE B. LOUIS MD
  • NPI Number: 1912914284
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 42D1040638
LAB Type Physician Office
Facility Name WILLIE B LOUIS MD PA
Street 1102 SUMMERS AVENUE
City ORANGEBURG
State SC
ZIP 29115
Phone 803 534-2270
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/1/2024
Certificate Expiration Date 10/31/2026
Facility Type Physician Office
Lab Director WILLIE B. LOUIS MD

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