42D2154656 CLIA NUMBER - CONCIERGE MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 42D2154656
  • Facility Name: CONCIERGE MEDICAL GROUP
  • Facility Address: 140 WILDEWOOD PARK DR SUITE 107
    COLUMBIA, SC
    ZIP 29223
  • Facility Phone: 803 722-4988
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: OLIVER HARDEN
  • NPI Number: 1811407521
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 42D2154656
LAB Type Mobile Laboratory
Facility Name CONCIERGE MEDICAL GROUP
Street 140 WILDEWOOD PARK DR SUITE 107
City COLUMBIA
State SC
ZIP 29223
Phone 803 722-4988
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/17/2024
Certificate Expiration Date 9/16/2026
Facility Type Mobile Laboratory
Lab Director OLIVER HARDEN

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