42D2114514 CLIA NUMBER - CENTERWELL SENIOR PRIMARY CARE - POWDERSVILLE

Laboratory Demographics

  • CLIA Code: 42D2114514
  • Facility Name: CENTERWELL SENIOR PRIMARY CARE - POWDERSVILLE
  • Facility Address: 3516 HIGHWAY 153
    GREENVILLE, SC
    ZIP 29611
  • Facility Phone: 305 500-2114
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ERICA SAVAGE-JETER
  • NPI Number: 1841644580
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 42D2114514
LAB Type Physician Office
Facility Name CENTERWELL SENIOR PRIMARY CARE - POWDERSVILLE
Street 3516 HIGHWAY 153
City GREENVILLE
State SC
ZIP 29611
Phone 305 500-2114
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/15/2024
Certificate Expiration Date 6/14/2026
Facility Type Physician Office
Lab Director ERICA SAVAGE-JETER

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