42D2059304 CLIA NUMBER - HEALTHSTAT ON-SITE CLINIC/ZEUS-MAGNOLIA

Laboratory Demographics

  • CLIA Code: 42D2059304
  • Facility Name: HEALTHSTAT ON-SITE CLINIC/ZEUS-MAGNOLIA
  • Facility Address: 620 MAGNOLIA ST
    ORANGEBURG, SC
    ZIP 29115
  • Facility Phone: 704 529-6161
  • Facility Type: Other - CHRONIC DISEASE MGMT
  • Facility Type: Waiver
  • Lab Director: DR. JAMES WEBB
  • NPI Number: 1568074656
  • Taxonomy: 2083P0500X - Preventive Medicine

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CLIA Record

Field Name Field Value
CLIA Number 42D2059304
LAB Type Other - CHRONIC DISEASE MGMT
Facility Name HEALTHSTAT ON-SITE CLINIC/ZEUS-MAGNOLIA
Street 620 MAGNOLIA ST
City ORANGEBURG
State SC
ZIP 29115
Phone 704 529-6161
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/21/2025
Certificate Expiration Date 5/20/2027
Facility Type Other - CHRONIC DISEASE MGMT
Lab Director DR. JAMES WEBB

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