42D1106283 CLIA NUMBER - CPG FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 42D1106283
  • Facility Name: CPG FAMILY MEDICINE
  • Facility Address: 51 11TH AVENUE
    AYNOR, SC
    ZIP 29511
  • Facility Phone: 843 358-3700
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DAVID JOHNSON
  • NPI Number: 1821335068
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 42D1106283
LAB Type Physician Office
Facility Name CPG FAMILY MEDICINE
Street 51 11TH AVENUE
City AYNOR
State SC
ZIP 29511
Phone 843 358-3700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/22/2025
Certificate Expiration Date 5/21/2027
Facility Type Physician Office
Lab Director DAVID JOHNSON

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