42D2145618 CLIA NUMBER - TIDEWATER DOCTORS LLC

Laboratory Demographics

  • CLIA Code: 42D2145618
  • Facility Name: TIDEWATER DOCTORS LLC
  • Facility Address: 2270 ASHLEY CROSSING DR, SUITE 155
    CHARLESTON, SC
    ZIP 29414
  • Facility Phone: 843 990-5866
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JEFFREY M. AKHTAR
  • NPI Number: 1821769290
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 42D2145618
LAB Type Physician Office
Facility Name TIDEWATER DOCTORS LLC
Street 2270 ASHLEY CROSSING DR, SUITE 155
City CHARLESTON
State SC
ZIP 29414
Phone 843 990-5866
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/13/2024
Certificate Expiration Date 3/12/2026
Facility Type Physician Office
Lab Director JEFFREY M. AKHTAR

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