42D2081814 CLIA NUMBER - FOOTHILLS COMMUNITY HEALTH CARE INC

Laboratory Demographics

  • CLIA Code: 42D2081814
  • Facility Name: FOOTHILLS COMMUNITY HEALTH CARE INC
  • Facility Address: 110 LIBERTY DRIVE
    CLEMSON, SC
    ZIP 29631
  • Facility Phone: 864 722-0283
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: DR. LAKRA MANJU
  • NPI Number: 1538417951
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 42D2081814
LAB Type Federally Qualified Health Center
Facility Name FOOTHILLS COMMUNITY HEALTH CARE INC
Street 110 LIBERTY DRIVE
City CLEMSON
State SC
ZIP 29631
Phone 864 722-0283
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/31/2024
Certificate Expiration Date 7/30/2026
Facility Type Federally Qualified Health Center
Lab Director DR. LAKRA MANJU

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This page was last updated on: 3/20/2025