42D1082661 CLIA NUMBER - JEDBURG DIALYSIS

Laboratory Demographics

  • CLIA Code: 42D1082661
  • Facility Name: JEDBURG DIALYSIS
  • Facility Address: 2897 W 5TH NORTH ST
    SUMMERVILLE, SC
    ZIP 29483
  • Facility Phone: 843 873-3955
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: SAMUEL C. FRANKLIN
  • NPI Number: 1578740387
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 42D1082661
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name JEDBURG DIALYSIS
Street 2897 W 5TH NORTH ST
City SUMMERVILLE
State SC
ZIP 29483
Phone 843 873-3955
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/16/2024
Certificate Expiration Date 4/15/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director SAMUEL C. FRANKLIN

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