42D2044909 CLIA NUMBER - PRISMA HEALTH HERITAGE PEDIATRICS AND INTERNAL MEDICINE-WREN

Laboratory Demographics

  • CLIA Code: 42D2044909
  • Facility Name: PRISMA HEALTH HERITAGE PEDIATRICS AND INTERNAL MEDICINE-WREN
  • Facility Address: 1115 WREN SCHOOL ROAD
    PIEDMONT, SC
    ZIP 29673
  • Facility Phone: 864 859-0740
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. GREGORY JOHNSON
  • NPI Number: 1588240493
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 42D2044909
LAB Type Physician Office
Facility Name PRISMA HEALTH HERITAGE PEDIATRICS AND INTERNAL MEDICINE-WREN
Street 1115 WREN SCHOOL ROAD
City PIEDMONT
State SC
ZIP 29673
Phone 864 859-0740
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/2/2024
Certificate Expiration Date 8/1/2026
Facility Type Physician Office
Lab Director DR. GREGORY JOHNSON

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