42D1069135 CLIA NUMBER - HEALTHSTAT, INC MILLIKEN - HILLCREST

Laboratory Demographics

  • CLIA Code: 42D1069135
  • Facility Name: HEALTHSTAT, INC MILLIKEN - HILLCREST
  • Facility Address: 2805 KEMET WAY
    SIMPSONVILLE, SC
    ZIP 29681
  • Facility Phone: 704 529-6161
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: JAMIE A. PUCKETT
  • NPI Number: 1215363437
  • Taxonomy: 2083P0500X - Preventive Medicine

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CLIA Record

Field Name Field Value
CLIA Number 42D1069135
LAB Type Other
Facility Name HEALTHSTAT, INC MILLIKEN - HILLCREST
Street 2805 KEMET WAY
City SIMPSONVILLE
State SC
ZIP 29681
Phone 704 529-6161
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/30/2025
Certificate Expiration Date 5/29/2027
Facility Type Other
Lab Director JAMIE A. PUCKETT

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