42D1045970 CLIA NUMBER - ORANGEBURG CBOC

Laboratory Demographics

  • CLIA Code: 42D1045970
  • Facility Name: ORANGEBURG CBOC
  • Facility Address: 1767 VILLAGEPARK DRIVE
    ORANGEBURG, SC
    ZIP 29118
  • Facility Phone: (803) 533-1335
  • Facility Type: Community Clinic
  • Facility Type: Accreditation
  • Lab Director: JAILAN M. OSMAN
  • NPI Number: 1003302795
  • Taxonomy: 2084P0800X - Psychiatry & Neurology

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CLIA Record

Field Name Field Value
CLIA Number 42D1045970
LAB Type Community Clinic
Facility Name ORANGEBURG CBOC
Street 1767 VILLAGEPARK DRIVE
City ORANGEBURG
State SC
ZIP 29118
Phone 8035331335
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 9/27/2005
Certificate Expiration Date 5/22/2026
Facility Type Community Clinic
Lab Director JAILAN M. OSMAN

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This page was last updated on: 5/18/2026