42D1054183 CLIA NUMBER - PALMETTO PRIMARY CARE PHYSICIANS-HAMPTON

Laboratory Demographics

  • CLIA Code: 42D1054183
  • Facility Name: PALMETTO PRIMARY CARE PHYSICIANS-HAMPTON
  • Facility Address: 300 MAPLE STREET, WEST
    HAMPTON, SC
    ZIP 29924
  • Facility Phone: 803 943-3813
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LUIS R. VEGA
  • NPI Number: 1710209564
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 42D1054183
LAB Type Physician Office
Facility Name PALMETTO PRIMARY CARE PHYSICIANS-HAMPTON
Street 300 MAPLE STREET, WEST
City HAMPTON
State SC
ZIP 29924
Phone 803 943-3813
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/13/2024
Certificate Expiration Date 5/12/2026
Facility Type Physician Office
Lab Director LUIS R. VEGA

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