42D2092410 CLIA NUMBER - GRACE MEDICAL TRANSPORT, LLC

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Laboratory Demographics

CLIA Number: 42D2092410

Facility Name: GRACE MEDICAL TRANSPORT, LLC

Facility Address:
1307A BROUGHTON BLVD
FLORENCE, SC
ZIP 29501
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Facility Phone Number: 843 799-0260

Facility Type: Ambulance

Certificate Type: Waiver

NPI Number: 1548651425

Taxonomy: 341600000X - Ambulance
An emergency vehicle used for transporting patients to a health care facility after injury or illness. Types of ambulances used in the United States include ground (surface) ambulance, rotor-wing (helicopter), and fixed-wing aircraft (airplane).

CLIA Record

Field Name	Field Value
CLIA Number	42D2092410
LAB Type	Ambulance
Facility Name	GRACE MEDICAL TRANSPORT, LLC
Street	1307A BROUGHTON BLVD
City	FLORENCE
State	SC
ZIP	29501
Phone	843 799-0260
CertificateType	4
CertificateEffectiveDate	3/4/2023
CertificateExpirationDate	3/3/2025
FacilityType	Waiver

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