42D1046782 CLIA NUMBER - CAROLINA PREVENTIVE MEDICINE ASSOCIATES

Laboratory Demographics

  • CLIA Code: 42D1046782
  • Facility Name: CAROLINA PREVENTIVE MEDICINE ASSOCIATES
  • Facility Address: 238 MATHIS FERRY ROAD, SUITE 103
    MOUNT PLEASANT, SC
    ZIP 29464
  • Facility Phone: 843 388-2400
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: WILLIAM WINGFIELD JR
  • NPI Number: 1255904538
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 42D1046782
LAB Type Physician Office
Facility Name CAROLINA PREVENTIVE MEDICINE ASSOCIATES
Street 238 MATHIS FERRY ROAD, SUITE 103
City MOUNT PLEASANT
State SC
ZIP 29464
Phone 843 388-2400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/18/2025
Certificate Expiration Date 10/17/2027
Facility Type Physician Office
Lab Director WILLIAM WINGFIELD JR

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