42D1084660 CLIA NUMBER - COASTAL WELLNESS

Laboratory Demographics

  • CLIA Code: 42D1084660
  • Facility Name: COASTAL WELLNESS
  • Facility Address: 4953 HIGHWAY 17 BYPASS S
    MYRTLE BEACH, SC
    ZIP 29577
  • Facility Phone: 888 403-2444
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. GERALD CONGDON
  • NPI Number: 1902077266
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 42D1084660
LAB Type Physician Office
Facility Name COASTAL WELLNESS
Street 4953 HIGHWAY 17 BYPASS S
City MYRTLE BEACH
State SC
ZIP 29577
Phone 888 403-2444
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/12/2025
Certificate Expiration Date 2/11/2027
Facility Type Physician Office
Lab Director DR. GERALD CONGDON

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