42D2123449 CLIA NUMBER - LAKESIDE MEDICAL RESPONSE

Laboratory Demographics

  • CLIA Code: 42D2123449
  • Facility Name: LAKESIDE MEDICAL RESPONSE
  • Facility Address: 1801-D WEST EVANS STREET SUITE 110
    FLORENCE, SC
    ZIP 29501
  • Facility Phone: 843 629-7133
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: SHAMEEKA S. MCDUFFIE
  • NPI Number: 1811085657
  • Taxonomy: 3416L0300X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 42D2123449
LAB Type Ambulance
Facility Name LAKESIDE MEDICAL RESPONSE
Street 1801-D WEST EVANS STREET SUITE 110
City FLORENCE
State SC
ZIP 29501
Phone 843 629-7133
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/21/2024
Certificate Expiration Date 12/20/2026
Facility Type Ambulance
Lab Director SHAMEEKA S. MCDUFFIE

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