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42D2141062 CLIA NUMBER - SOUTHERN MED PEDIATRICS FORT MILL

Laboratory Demographics

CLIA Number: 42D2141062

Facility Name: SOUTHERN MED PEDIATRICS FORT MILL

Facility Address:
342 PATRICIA LN, SUITE 105
FORT MILL, SC
ZIP 29708
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Facility Phone Number: 803 520-9380

Facility Type: Physician Office

Certificate Type: Certificate of Compliance
NPI Number: 1114196557

Taxonomy: 208000000X - Pediatrics
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

CLIA Record

Field Name Field Value
CLIA Number 42D2141062
LAB Type Physician Office
Facility Name SOUTHERN MED PEDIATRICS FORT MILL
Street 342 PATRICIA LN, SUITE 105
City FORT MILL
State SC
ZIP 29708
Phone 803 520-9380
CertificateType 2
CertificateEffectiveDate 1/29/2022
CertificateExpirationDate 4/30/2024
FacilityType Compliance

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