42D2068537 CLIA NUMBER - TRIDENT PAIN CENTER, LLC MONCKS CORNER

Laboratory Demographics

  • CLIA Code: 42D2068537
  • Facility Name: TRIDENT PAIN CENTER, LLC MONCKS CORNER
  • Facility Address: 108 NORTH HIGHWAY 52
    MONCKS CORNER, SC
    ZIP 29461
  • Facility Phone: 843 797-3636
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOSEPH E. NOLAN
  • NPI Number: 1154757482
  • Taxonomy: 207LP2900X - Anesthesiology

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CLIA Record

Field Name Field Value
CLIA Number 42D2068537
LAB Type Physician Office
Facility Name TRIDENT PAIN CENTER, LLC MONCKS CORNER
Street 108 NORTH HIGHWAY 52
City MONCKS CORNER
State SC
ZIP 29461
Phone 843 797-3636
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/6/2023
Certificate Expiration Date 11/5/2025
Facility Type Physician Office
Lab Director JOSEPH E. NOLAN

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