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42D1059598 CLIA NUMBER - CAROLINAS CENTER FOR DIABETES & ENDOCRINOLOGY VILLAGE AT PELHAM

Laboratory Demographics

CLIA Number: 42D1059598

Facility Name: CAROLINAS CENTER FOR DIABETES & ENDOCRINOLOGY VILLAGE AT PELHAM

Facility Address:
2755 S HWY 14 STE 1200K
GREER, SC
ZIP 29650
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Facility Phone Number: 864 849-9336

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1720556376

Taxonomy: 207QA0401X - Family Medicine
A family medicine physician who specializes in the diagnosis and treatment of addictions.

CLIA Record

Field Name Field Value
CLIA Number 42D1059598
LAB Type Physician Office
Facility Name CAROLINAS CENTER FOR DIABETES & ENDOCRINOLOGY VILLAGE AT PELHAM
Street 2755 S HWY 14 STE 1200K
City GREER
State SC
ZIP 29650
Phone 864 849-9336
CertificateType 4
CertificateEffectiveDate 10/3/2022
CertificateExpirationDate 10/2/2024
FacilityType Waiver

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