42D1078780 CLIA NUMBER - NOVANT HEALTH SOUTHEASTERN SPINE INSTITUTE

Laboratory Demographics

  • CLIA Code: 42D1078780
  • Facility Name: NOVANT HEALTH SOUTHEASTERN SPINE INSTITUTE
  • Facility Address: 1625 HOSPITAL DRIVE
    MT PLEASANT, SC
    ZIP 29464
  • Facility Phone: 843 849-1551
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SANDY CHALKER
  • NPI Number: 1679014138
  • Taxonomy: 207W00000X - Ophthalmology

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CLIA Record

Field Name Field Value
CLIA Number 42D1078780
LAB Type Physician Office
Facility Name NOVANT HEALTH SOUTHEASTERN SPINE INSTITUTE
Street 1625 HOSPITAL DRIVE
City MT PLEASANT
State SC
ZIP 29464
Phone 843 849-1551
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/16/2024
Certificate Expiration Date 1/15/2026
Facility Type Physician Office
Lab Director SANDY CHALKER

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