42D2018993 CLIA NUMBER - NOVANT HEALTH ISLAND PARK FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 42D2018993
  • Facility Name: NOVANT HEALTH ISLAND PARK FAMILY MEDICINE
  • Facility Address: 880 ISLAND PARK DRIVE SUITE #200
    DANIEL ISLAND, SC
    ZIP 29492
  • Facility Phone: 843 856-1771
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOHN INMAN
  • NPI Number: 1972374601
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 42D2018993
LAB Type Physician Office
Facility Name NOVANT HEALTH ISLAND PARK FAMILY MEDICINE
Street 880 ISLAND PARK DRIVE SUITE #200
City DANIEL ISLAND
State SC
ZIP 29492
Phone 843 856-1771
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/20/2025
Certificate Expiration Date 1/19/2027
Facility Type Physician Office
Lab Director JOHN INMAN

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