42D2039577 CLIA NUMBER - THOMAS UPSHAW, MD PA

Laboratory Demographics

  • CLIA Code: 42D2039577
  • Facility Name: THOMAS UPSHAW, MD PA
  • Facility Address: 728 S SHELMORE BLVD, SUITE 103
    MT PLEASANT, SC
    ZIP 29464
  • Facility Phone: 843 972-0262
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: THOMAS UPSHAW
  • NPI Number: 1306002142
  • Taxonomy: 2084P0800X - Psychiatry & Neurology

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CLIA Record

Field Name Field Value
CLIA Number 42D2039577
LAB Type Physician Office
Facility Name THOMAS UPSHAW, MD PA
Street 728 S SHELMORE BLVD, SUITE 103
City MT PLEASANT
State SC
ZIP 29464
Phone 843 972-0262
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/12/2024
Certificate Expiration Date 4/11/2026
Facility Type Physician Office
Lab Director THOMAS UPSHAW

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