42D1047289 CLIA NUMBER - TRI-COUNTY PEDIATRICS LLC

Laboratory Demographics

  • CLIA Code: 42D1047289
  • Facility Name: TRI-COUNTY PEDIATRICS LLC
  • Facility Address: 815 EAST LIBERTY STREET
    YORK, SC
    ZIP 29745
  • Facility Phone: 803 628-2728
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GAURANG C. SHAH MD
  • NPI Number: 1114066883
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 42D1047289
LAB Type Physician Office
Facility Name TRI-COUNTY PEDIATRICS LLC
Street 815 EAST LIBERTY STREET
City YORK
State SC
ZIP 29745
Phone 803 628-2728
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/31/2023
Certificate Expiration Date 10/30/2025
Facility Type Physician Office
Lab Director GAURANG C. SHAH MD

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