42D1069134 CLIA NUMBER - HEALTHSTAT, INC MILLIKEN - CYPRESS

Laboratory Demographics

CLIA Number: 42D1069134

Facility Name: HEALTHSTAT, INC MILLIKEN - CYPRESS

Facility Address:
164 MILLIKEN ROAD
BLACKSBURG, SC
ZIP 29702
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Facility Phone Number: 704 529-6161

Facility Type: Other

Certificate Type: Waiver

NPI Number: 1821424045

Taxonomy: 2083P0500X - Preventive Medicine
A preventive medicine physician who specializes in preventive medicine/occupational-environmental medicine, which is focused on protecting the population from occupational and environmental conditions.

CLIA Record

Field Name	Field Value
CLIA Number	42D1069134
LAB Type	Other
Facility Name	HEALTHSTAT, INC MILLIKEN - CYPRESS
Street	164 MILLIKEN ROAD
City	BLACKSBURG
State	SC
ZIP	29702
Phone	704 529-6161
CertificateType	4
CertificateEffectiveDate	5/30/2023
CertificateExpirationDate	5/29/2025
FacilityType	Waiver

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