42D2132752 CLIA NUMBER - MONCKS CORNER FIRE DEPARTMENT

Laboratory Demographics

CLIA Number: 42D2132752

Facility Name: MONCKS CORNER FIRE DEPARTMENT

Facility Address:
116 CAROLINA AVE
MONCKS CORNER, SC
ZIP 29461
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Facility Phone Number: 843 719-7990

Facility Type: Other - FIRE DEPT BLS NON TRANSPO

Certificate Type: Waiver

NPI Number: 1003070103

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	42D2132752
LAB Type	Other - FIRE DEPT BLS NON TRANSPO
Facility Name	MONCKS CORNER FIRE DEPARTMENT
Street	116 CAROLINA AVE
City	MONCKS CORNER
State	SC
ZIP	29461
Phone	843 719-7990
CertificateType	4
CertificateEffectiveDate	6/27/2023
CertificateExpirationDate	6/26/2025
FacilityType	Waiver

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