42D1077946 CLIA NUMBER - PROFESSIONAL PATHOLOGY ASSOCIATES INC

Laboratory Demographics

  • CLIA Code: 42D1077946
  • Facility Name: PROFESSIONAL PATHOLOGY ASSOCIATES INC
  • Facility Address: 176 DERMIS AVE SUITE 101
    HARDEEVILLE, SC
    ZIP 29927
  • Facility Phone: 912 261-2669
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: DR. CAROLYN WALL
  • NPI Number: 1275631715
  • Taxonomy: 207ZP0102X - Pathology

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CLIA Record

Field Name Field Value
CLIA Number 42D1077946
LAB Type Physician Office
Facility Name PROFESSIONAL PATHOLOGY ASSOCIATES INC
Street 176 DERMIS AVE SUITE 101
City HARDEEVILLE
State SC
ZIP 29927
Phone 912 261-2669
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 6/17/2024
Certificate Expiration Date 6/16/2026
Facility Type Physician Office
Lab Director DR. CAROLYN WALL

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