42D2084085 CLIA NUMBER - FORK RESCUE SQUAD

Laboratory Demographics

  • CLIA Code: 42D2084085
  • Facility Name: FORK RESCUE SQUAD
  • Facility Address: 8513 HWY 24
    TOWNVILLE, SC
    ZIP 29689
  • Facility Phone: 864 287-4882
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: JONATHAN M. BRYANT
  • NPI Number: 1598787467
  • Taxonomy: 3416L0300X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 42D2084085
LAB Type Ambulance
Facility Name FORK RESCUE SQUAD
Street 8513 HWY 24
City TOWNVILLE
State SC
ZIP 29689
Phone 864 287-4882
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/18/2024
Certificate Expiration Date 9/17/2026
Facility Type Ambulance
Lab Director JONATHAN M. BRYANT

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