42D1054162 CLIA NUMBER - MYRTLE BEACH DIALYSIS

Laboratory Demographics

  • CLIA Code: 42D1054162
  • Facility Name: MYRTLE BEACH DIALYSIS
  • Facility Address: 3919 MAYFAIR DR
    MYRTLE BEACH, SC
    ZIP 29577
  • Facility Phone: 843 448-4820
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: SHERGILL KARANDEEP
  • NPI Number: 1962480046
  • Taxonomy: 332BC3200X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 42D1054162
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name MYRTLE BEACH DIALYSIS
Street 3919 MAYFAIR DR
City MYRTLE BEACH
State SC
ZIP 29577
Phone 843 448-4820
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/15/2024
Certificate Expiration Date 5/14/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director SHERGILL KARANDEEP

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