42D2150413 CLIA NUMBER - PVD INTERNAL MEDICINE ASSOCIATES

Laboratory Demographics

  • CLIA Code: 42D2150413
  • Facility Name: PVD INTERNAL MEDICINE ASSOCIATES
  • Facility Address: 3000 WOODSIDE EXECUTIVE COURT
    AIKEN, SC
    ZIP 29803
  • Facility Phone: 803 226-0343
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ALYSSA M. DEGNAN
  • NPI Number: 1962995100
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 42D2150413
LAB Type Physician Office
Facility Name PVD INTERNAL MEDICINE ASSOCIATES
Street 3000 WOODSIDE EXECUTIVE COURT
City AIKEN
State SC
ZIP 29803
Phone 803 226-0343
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/25/2024
Certificate Expiration Date 6/24/2026
Facility Type Physician Office
Lab Director ALYSSA M. DEGNAN

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