42D1067277 CLIA NUMBER - FOREST FAMILY CARE, INC

Laboratory Demographics

  • CLIA Code: 42D1067277
  • Facility Name: FOREST FAMILY CARE, INC
  • Facility Address: 3874 RENEE DRIVE, SUITE B
    MYRTLE BEACH, SC
    ZIP 29579
  • Facility Phone: 843 903-4500
  • Facility Type: Practitioner Other
  • Facility Type: Microscopy
  • Lab Director: JESSICA G. SMITH-CHASSE
  • NPI Number: 1568585966
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 42D1067277
LAB Type Practitioner Other
Facility Name FOREST FAMILY CARE, INC
Street 3874 RENEE DRIVE, SUITE B
City MYRTLE BEACH
State SC
ZIP 29579
Phone 843 903-4500
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 4/16/2025
Certificate Expiration Date 4/15/2027
Facility Type Practitioner Other
Lab Director JESSICA G. SMITH-CHASSE

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