42D2137258 CLIA NUMBER - TOBY'S PLACE

Laboratory Demographics

CLIA Number: 42D2137258

Facility Name: TOBY'S PLACE

Facility Address:
5938 TWO NOTCH RD
COLUMBIA, SC
ZIP 29223
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Facility Phone Number: 803 733-5969

Facility Type: Federally Qualified Health Center

Certificate Type: Waiver

NPI Number: 1861082422

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	42D2137258
LAB Type	Federally Qualified Health Center
Facility Name	TOBY'S PLACE
Street	5938 TWO NOTCH RD
City	COLUMBIA
State	SC
ZIP	29223
Phone	803 733-5969
CertificateType	4
CertificateEffectiveDate	9/28/2023
CertificateExpirationDate	9/27/2025
FacilityType	Waiver

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