42D1090733 CLIA NUMBER - SOUTH CAROLINA DEPARTMENT OF MENTAL HEALTH

Laboratory Demographics

CLIA Number: 42D1090733

Facility Name: SOUTH CAROLINA DEPARTMENT OF MENTAL HEALTH

Facility Address:
2414 BULL STREET
COLUMBIA, SC
ZIP 29201
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Facility Phone Number: 803 898-4802

Facility Type: Community Clinic

Certificate Type: Waiver

NPI Number: 1922164326

Taxonomy: 251K00000X - Public Health or Welfare

CLIA Record

Field Name	Field Value
CLIA Number	42D1090733
LAB Type	Community Clinic
Facility Name	SOUTH CAROLINA DEPARTMENT OF MENTAL HEALTH
Street	2414 BULL STREET
City	COLUMBIA
State	SC
ZIP	29201
Phone	803 898-4802
CertificateType	4
CertificateEffectiveDate	5/3/2022
CertificateExpirationDate	5/2/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024