42D1057510 CLIA NUMBER - ACTIVE DAY OF BOILING SPRINGS

Laboratory Demographics

CLIA Number: 42D1057510

Facility Name: ACTIVE DAY OF BOILING SPRINGS

Facility Address:
230 GILES DR
BOILING SPRINGS, SC
ZIP 29316
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Facility Phone Number: 864 599-7342

Facility Type: Other

Certificate Type: Waiver

NPI Number: 1336696731

Taxonomy: 261QA0600X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	42D1057510
LAB Type	Other
Facility Name	ACTIVE DAY OF BOILING SPRINGS
Street	230 GILES DR
City	BOILING SPRINGS
State	SC
ZIP	29316
Phone	864 599-7342
CertificateType	4
CertificateEffectiveDate	8/15/2022
CertificateExpirationDate	8/14/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024