42D2095091 CLIA NUMBER - PROACTIVE MD AT CITY OF SPARTANBURG PUBLIC WORKS

Laboratory Demographics

  • CLIA Code: 42D2095091
  • Facility Name: PROACTIVE MD AT CITY OF SPARTANBURG PUBLIC WORKS
  • Facility Address: 801 UNION STREET
    SPARTANBURG, SC
    ZIP 29302
  • Facility Phone: 864 596-2872
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: LAURA MORRISON
  • NPI Number: 1073171336
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 42D2095091
LAB Type Practitioner Other
Facility Name PROACTIVE MD AT CITY OF SPARTANBURG PUBLIC WORKS
Street 801 UNION STREET
City SPARTANBURG
State SC
ZIP 29302
Phone 864 596-2872
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/29/2025
Certificate Expiration Date 4/28/2027
Facility Type Practitioner Other
Lab Director LAURA MORRISON

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