42D2096963 CLIA NUMBER - MICHELIN NORTH AMERICA-DONALDSON CAMPUS

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Laboratory Demographics

CLIA Number: 42D2096963

Facility Name: MICHELIN NORTH AMERICA-DONALDSON CAMPUS

Facility Address:
515 MICHELIN ROAD, BUILDING 95
GREENVILLE, SC
ZIP 29605
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Facility Phone Number: 864 422-3552

Facility Type: Independent

Certificate Type: Waiver

NPI Number: 1124315817

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	42D2096963
LAB Type	Independent
Facility Name	MICHELIN NORTH AMERICA-DONALDSON CAMPUS
Street	515 MICHELIN ROAD, BUILDING 95
City	GREENVILLE
State	SC
ZIP	29605
Phone	864 422-3552
CertificateType	4
CertificateEffectiveDate	6/4/2023
CertificateExpirationDate	6/3/2025
FacilityType	Waiver

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