42D2122625 CLIA NUMBER - PROACTIVE MD TINDALL CORPORATION HEALTH CENTER - SPTG

Laboratory Demographics

  • CLIA Code: 42D2122625
  • Facility Name: PROACTIVE MD TINDALL CORPORATION HEALTH CENTER - SPTG
  • Facility Address: 2273 HAYNE STREET
    SPARTANBURG, SC
    ZIP 29301
  • Facility Phone: 864 541-0555
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: DR. JOY HUDSON
  • NPI Number: 1033716253
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 42D2122625
LAB Type Practitioner Other
Facility Name PROACTIVE MD TINDALL CORPORATION HEALTH CENTER - SPTG
Street 2273 HAYNE STREET
City SPARTANBURG
State SC
ZIP 29301
Phone 864 541-0555
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/1/2024
Certificate Expiration Date 11/30/2026
Facility Type Practitioner Other
Lab Director DR. JOY HUDSON

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