42D1069142 CLIA NUMBER - HEALTHSTAT, INC MILLIKEN - CEDAR HILL

Laboratory Demographics

CLIA Number: 42D1069142

Facility Name: HEALTHSTAT, INC MILLIKEN - CEDAR HILL

Facility Address:
225 BOB LITTLE ROAD
JONESVILLE, SC
ZIP 29353
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Facility Phone Number: 704 529-6161

Facility Type: Other

Certificate Type: Waiver

NPI Number: 1114352143

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	42D1069142
LAB Type	Other
Facility Name	HEALTHSTAT, INC MILLIKEN - CEDAR HILL
Street	225 BOB LITTLE ROAD
City	JONESVILLE
State	SC
ZIP	29353
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