42D2157085 CLIA NUMBER - HIGH TIDE INTERNAL MEDICINE

Laboratory Demographics

  • CLIA Code: 42D2157085
  • Facility Name: HIGH TIDE INTERNAL MEDICINE
  • Facility Address: 1280 HOSPITAL DRIVE SUITE 201
    MOUNT PLEASANT, SC
    ZIP 29464
  • Facility Phone: 843 291-4422
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ANNA MORGAN
  • NPI Number: 1609637750
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 42D2157085
LAB Type Physician Office
Facility Name HIGH TIDE INTERNAL MEDICINE
Street 1280 HOSPITAL DRIVE SUITE 201
City MOUNT PLEASANT
State SC
ZIP 29464
Phone 843 291-4422
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/30/2024
Certificate Expiration Date 10/29/2026
Facility Type Physician Office
Lab Director ANNA MORGAN

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