42D2092626 CLIA NUMBER - LIFELINE AMBULANCE

Laboratory Demographics

  • CLIA Code: 42D2092626
  • Facility Name: LIFELINE AMBULANCE
  • Facility Address: 16 DOOLEY DRIVE
    LUGOFF, SC
    ZIP 29078
  • Facility Phone: 803 243-2434
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: MR. RUSS C. COBB
  • NPI Number: 1235434853
  • Taxonomy: 341600000X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 42D2092626
LAB Type Ambulance
Facility Name LIFELINE AMBULANCE
Street 16 DOOLEY DRIVE
City LUGOFF
State SC
ZIP 29078
Phone 803 243-2434
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/10/2025
Certificate Expiration Date 3/9/2027
Facility Type Ambulance
Lab Director MR. RUSS C. COBB

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