42D1043549 CLIA NUMBER - GROSS FAMILY PRACTICE RACHAEL E GROSS DO

Laboratory Demographics

  • CLIA Code: 42D1043549
  • Facility Name: GROSS FAMILY PRACTICE RACHAEL E GROSS DO
  • Facility Address: 970 HOLLY ST
    ORANGEBURG, SC
    ZIP 29115
  • Facility Phone: 803 531-2722
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RACHAEL E. GROSS DO
  • NPI Number: 1417174806
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 42D1043549
LAB Type Physician Office
Facility Name GROSS FAMILY PRACTICE RACHAEL E GROSS DO
Street 970 HOLLY ST
City ORANGEBURG
State SC
ZIP 29115
Phone 803 531-2722
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/27/2023
Certificate Expiration Date 7/26/2025
Facility Type Physician Office
Lab Director RACHAEL E. GROSS DO

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This page was last updated on: 6/4/2025