42D1075181 CLIA NUMBER - NOVANT HEALTH URGENT CARE CAROLINA FOREST

Laboratory Demographics

  • CLIA Code: 42D1075181
  • Facility Name: NOVANT HEALTH URGENT CARE CAROLINA FOREST
  • Facility Address: 200 MIDDLEBURG DR
    MYRTLE BEACH, SC
    ZIP 29579
  • Facility Phone: 803 782-4278
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. SHELLEY L. JANSSEN
  • NPI Number: 1295074276
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 42D1075181
LAB Type Physician Office
Facility Name NOVANT HEALTH URGENT CARE CAROLINA FOREST
Street 200 MIDDLEBURG DR
City MYRTLE BEACH
State SC
ZIP 29579
Phone 803 782-4278
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/1/2024
Certificate Expiration Date 6/30/2026
Facility Type Physician Office
Lab Director DR. SHELLEY L. JANSSEN

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