42D2010884 CLIA NUMBER - SJC CENTER FOR MEDICATION MANAGEMENT

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Laboratory Demographics

CLIA Number: 42D2010884

Facility Name: SJC CENTER FOR MEDICATION MANAGEMENT

Facility Address:
12B ARLEY WAY, SUITE 103
BLUFFTON, SC
ZIP 29910
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Facility Phone Number: 843 815-2949

Facility Type: Hospital

Certificate Type: Waiver

NPI Number: 1548656549

Taxonomy: 101YM0800X - Counselor

CLIA Record

Field Name	Field Value
CLIA Number	42D2010884
LAB Type	Hospital
Facility Name	SJC CENTER FOR MEDICATION MANAGEMENT
Street	12B ARLEY WAY, SUITE 103
City	BLUFFTON
State	SC
ZIP	29910
Phone	843 815-2949
CertificateType	4
CertificateEffectiveDate	10/19/2023
CertificateExpirationDate	10/18/2025
FacilityType	Waiver

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