42D2008498 CLIA NUMBER - GREENVILLE COUNTY DETENTION MEDICAL CLINIC

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Laboratory Demographics

CLIA Number: 42D2008498

Facility Name: GREENVILLE COUNTY DETENTION MEDICAL CLINIC

Facility Address:
20 MCGEE STREET ATTN CARMEN HALL/MEDICAL DEPT
GREENVILLE, SC
ZIP 29601
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Facility Phone Number: 864 467-2317

Facility Type: Other - DETENTION CENTER JAIL

Certificate Type: Microscopy

NPI Number: 1114290368

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	42D2008498
LAB Type	Other - DETENTION CENTER JAIL
Facility Name	GREENVILLE COUNTY DETENTION MEDICAL CLINIC
Street	20 MCGEE STREET ATTN CARMEN HALL/MEDICAL DEPT
City	GREENVILLE
State	SC
ZIP	29601
Phone	864 467-2317
CertificateType	3
CertificateEffectiveDate	4/1/2023
CertificateExpirationDate	3/31/2025
FacilityType	PPMP

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