42D1081083 CLIA NUMBER - INMED DIAGNOSTICS OF SC LLC

Laboratory Demographics

  • CLIA Code: 42D1081083
  • Facility Name: INMED DIAGNOSTICS OF SC LLC
  • Facility Address: 1728 VILLAGE PARK DRIVE
    ORANGEBURG, SC
    ZIP 29118
  • Facility Phone: 803 536-1106
  • Facility Type: Other - IDTF
  • Facility Type: Waiver
  • Lab Director: RICKY D. MOORE
  • NPI Number: 1164591756
  • Taxonomy: 2085R0202X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 42D1081083
LAB Type Other - IDTF
Facility Name INMED DIAGNOSTICS OF SC LLC
Street 1728 VILLAGE PARK DRIVE
City ORANGEBURG
State SC
ZIP 29118
Phone 803 536-1106
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/10/2024
Certificate Expiration Date 3/9/2026
Facility Type Other - IDTF
Lab Director RICKY D. MOORE

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