42D1050920 CLIA NUMBER - CSRA RENAL SERVICES LLC

Laboratory Demographics

  • CLIA Code: 42D1050920
  • Facility Name: CSRA RENAL SERVICES LLC
  • Facility Address: 10708 MARLBORO AVE
    BARNWELL, SC
    ZIP 29812
  • Facility Phone: 803 648-0718
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DOUGLAS A. STAHURA DO
  • NPI Number: 1295799641
  • Taxonomy: 207RN0300X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 42D1050920
LAB Type Physician Office
Facility Name CSRA RENAL SERVICES LLC
Street 10708 MARLBORO AVE
City BARNWELL
State SC
ZIP 29812
Phone 803 648-0718
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/12/2023
Certificate Expiration Date 12/11/2025
Facility Type Physician Office
Lab Director DOUGLAS A. STAHURA DO

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