42D2152884 CLIA NUMBER - ROSE D GIBBS FAMILY HEALTH CENTER

Laboratory Demographics

  • CLIA Code: 42D2152884
  • Facility Name: ROSE D GIBBS FAMILY HEALTH CENTER
  • Facility Address: 106 WEST MAIN STREET
    MONCKS CORNER, SC
    ZIP 29461
  • Facility Phone: 843 722-4112
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Microscopy
  • Lab Director: DANA LAFORTE
  • NPI Number: 1548299159
  • Taxonomy: 207R00000X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 42D2152884
LAB Type Federally Qualified Health Center
Facility Name ROSE D GIBBS FAMILY HEALTH CENTER
Street 106 WEST MAIN STREET
City MONCKS CORNER
State SC
ZIP 29461
Phone 843 722-4112
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 8/17/2024
Certificate Expiration Date 8/16/2026
Facility Type Federally Qualified Health Center
Lab Director DANA LAFORTE

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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