42D1044508 CLIA NUMBER - AID UPSTATE

Laboratory Demographics

  • CLIA Code: 42D1044508
  • Facility Name: AID UPSTATE
  • Facility Address: 811 PENDLETON ST BLDG #10
    GREENVILLE, SC
    ZIP 29601
  • Facility Phone: 864 250-0607
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: BRIAN LUM
  • NPI Number: 1023563459
  • Taxonomy: 261QM2500X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 42D1044508
LAB Type Other
Facility Name AID UPSTATE
Street 811 PENDLETON ST BLDG #10
City GREENVILLE
State SC
ZIP 29601
Phone 864 250-0607
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/22/2025
Certificate Expiration Date 8/21/2027
Facility Type Other
Lab Director BRIAN LUM

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