42D1059096 CLIA NUMBER - NOVANT HEALTH URGENT CARE IVY HALL

Laboratory Demographics

  • CLIA Code: 42D1059096
  • Facility Name: NOVANT HEALTH URGENT CARE IVY HALL
  • Facility Address: 3074 HWY 17N
    MOUNT PLEASANT, SC
    ZIP 29466
  • Facility Phone: 843 884-6424
  • Facility Type: Other - URGENT CARE
  • Facility Type: Waiver
  • Lab Director: DR. SHELLEY L. JANSSEN
  • NPI Number: 1598004509
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 42D1059096
LAB Type Other - URGENT CARE
Facility Name NOVANT HEALTH URGENT CARE IVY HALL
Street 3074 HWY 17N
City MOUNT PLEASANT
State SC
ZIP 29466
Phone 843 884-6424
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/31/2024
Certificate Expiration Date 5/30/2026
Facility Type Other - URGENT CARE
Lab Director DR. SHELLEY L. JANSSEN

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