42D2082247 CLIA NUMBER - CHARLESTON COUNTY EMS

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Laboratory Demographics

CLIA Number: 42D2082247

Facility Name: CHARLESTON COUNTY EMS

Facility Address:
4045 BRIDGEVIEW DRIVE, STE B309
NORTH CHARLESTON, SC
ZIP 29405
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Facility Phone Number: 843 202-6700

Facility Type: Ambulance

Certificate Type: Waiver

NPI Number: 1538636964

Taxonomy: 1223S0112X - Dentist
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

CLIA Record

Field Name	Field Value
CLIA Number	42D2082247
LAB Type	Ambulance
Facility Name	CHARLESTON COUNTY EMS
Street	4045 BRIDGEVIEW DRIVE, STE B309
City	NORTH CHARLESTON
State	SC
ZIP	29405
Phone	843 202-6700
CertificateType	4
CertificateEffectiveDate	8/11/2022
CertificateExpirationDate	8/10/2024
FacilityType	Waiver

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