42D1079049 CLIA NUMBER - NOVANT HEALTH URGENT CARE SOUTH IRBY

Laboratory Demographics

  • CLIA Code: 42D1079049
  • Facility Name: NOVANT HEALTH URGENT CARE SOUTH IRBY
  • Facility Address: 2200 SOUTH IRBY ST
    FLORENCE, SC
    ZIP 29505
  • Facility Phone: 803 782-4278
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SHELLEY L. JANSSEN
  • NPI Number: 1124367016
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 42D1079049
LAB Type Physician Office
Facility Name NOVANT HEALTH URGENT CARE SOUTH IRBY
Street 2200 SOUTH IRBY ST
City FLORENCE
State SC
ZIP 29505
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 5/17/2024
Certificate Expiration Date 5/16/2026
Facility Type Physician Office
Lab Director SHELLEY L. JANSSEN

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