42D1096996 CLIA NUMBER - PALMETTO PAIN CENTER

Laboratory Demographics

CLIA Number: 42D1096996

Facility Name: PALMETTO PAIN CENTER

Facility Address:
41 A MARSHELLEN DR
BEAUFORT, SC
ZIP 29902
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Facility Phone Number: 843 522-3456

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1275618332

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	42D1096996
LAB Type	Physician Office
Facility Name	PALMETTO PAIN CENTER
Street	41 A MARSHELLEN DR
City	BEAUFORT
State	SC
ZIP	29902
Phone	843 522-3456
CertificateType	4
CertificateEffectiveDate	3/17/2023
CertificateExpirationDate	3/16/2025
FacilityType	Waiver

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