42D2019632 CLIA NUMBER - MUSC SPECIALTY CARE WEST ASHLEY

Laboratory Demographics

  • CLIA Code: 42D2019632
  • Facility Name: MUSC SPECIALTY CARE WEST ASHLEY
  • Facility Address: 2075 CHARLIE HALL BLVD
    CHARLESTON, SC
    ZIP 29414
  • Facility Phone: 843 876-3151
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. JUSTIN DEAN
  • NPI Number: 1689753519
  • Taxonomy: 282N00000X - General Acute Care Hospital

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CLIA Record

Field Name Field Value
CLIA Number 42D2019632
LAB Type Physician Office
Facility Name MUSC SPECIALTY CARE WEST ASHLEY
Street 2075 CHARLIE HALL BLVD
City CHARLESTON
State SC
ZIP 29414
Phone 843 876-3151
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 2/3/2025
Certificate Expiration Date 2/2/2027
Facility Type Physician Office
Lab Director DR. JUSTIN DEAN

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