42D2104704 CLIA NUMBER - CHESTERFIELD COUNTY JAIL

Laboratory Demographics

  • CLIA Code: 42D2104704
  • Facility Name: CHESTERFIELD COUNTY JAIL
  • Facility Address: 319 GOODALE RD
    CHESTERFIELD, SC
    ZIP 29709
  • Facility Phone: 423 553-5635
  • Facility Type: Other - JAIL MEDICAL UNIT
  • Facility Type: Waiver
  • Lab Director: CHARLES A. BUSH
  • NPI Number: 1457887747
  • Taxonomy: 341600000X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 42D2104704
LAB Type Other - JAIL MEDICAL UNIT
Facility Name CHESTERFIELD COUNTY JAIL
Street 319 GOODALE RD
City CHESTERFIELD
State SC
ZIP 29709
Phone 423 553-5635
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/10/2023
Certificate Expiration Date 11/9/2025
Facility Type Other - JAIL MEDICAL UNIT
Lab Director CHARLES A. BUSH

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