42D2053636 CLIA NUMBER - ERNEST E KENNEDY CENTER

Laboratory Demographics

  • CLIA Code: 42D2053636
  • Facility Name: ERNEST E KENNEDY CENTER
  • Facility Address: 306 AIRPORT DRIVE
    MONCKS CORNER, SC
    ZIP 29461
  • Facility Phone: 843 761-8272
  • Facility Type: Other - OUTPATIENT SUBSTANCE ABUS
  • Facility Type: Waiver
  • Lab Director: WEHME HUTTO
  • NPI Number: 1750406476
  • Taxonomy: 101YP2500X - Counselor

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CLIA Record

Field Name Field Value
CLIA Number 42D2053636
LAB Type Other - OUTPATIENT SUBSTANCE ABUS
Facility Name ERNEST E KENNEDY CENTER
Street 306 AIRPORT DRIVE
City MONCKS CORNER
State SC
ZIP 29461
Phone 843 761-8272
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/5/2025
Certificate Expiration Date 2/4/2027
Facility Type Other - OUTPATIENT SUBSTANCE ABUS
Lab Director WEHME HUTTO

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