42D2072807 CLIA NUMBER - LEXINGTON COUNTY WELLNESS CENTER

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Laboratory Demographics

CLIA Number: 42D2072807

Facility Name: LEXINGTON COUNTY WELLNESS CENTER

Facility Address:
605 WEST MAIN STREET
LEXINGTON, SC
ZIP 29072
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Facility Phone Number: 802 857-0400

Facility Type: Other - ONSITE HEALTH CENTER

Certificate Type: Waiver

NPI Number: 1194753053

Taxonomy: 261QR0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	42D2072807
LAB Type	Other - ONSITE HEALTH CENTER
Facility Name	LEXINGTON COUNTY WELLNESS CENTER
Street	605 WEST MAIN STREET
City	LEXINGTON
State	SC
ZIP	29072
Phone	802 857-0400
CertificateType	4
CertificateEffectiveDate	2/5/2024
CertificateExpirationDate	2/4/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024