42D2157360 CLIA NUMBER - COLUMBIA NEPHROLOGY ASSOCIATES, PA

Laboratory Demographics

CLIA Number: 42D2157360

Facility Name: COLUMBIA NEPHROLOGY ASSOCIATES, PA

Facility Address:
3630 SUNSET BLVD
WEST COLUMBIA, SC
ZIP 29169
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Facility Phone Number: 803 252-9907

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1780180596

Taxonomy: 261QM2500X - Clinic/Center
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).

CLIA Record

Field Name	Field Value
CLIA Number	42D2157360
LAB Type	Physician Office
Facility Name	COLUMBIA NEPHROLOGY ASSOCIATES, PA
Street	3630 SUNSET BLVD
City	WEST COLUMBIA
State	SC
ZIP	29169
Phone	803 252-9907
CertificateType	4
CertificateEffectiveDate	11/5/2022
CertificateExpirationDate	11/4/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024