42D2158713 CLIA NUMBER - SOUTH CAROLINA CENTER FOR INTEGRATIVE MEDICINE

Laboratory Demographics

  • CLIA Code: 42D2158713
  • Facility Name: SOUTH CAROLINA CENTER FOR INTEGRATIVE MEDICINE
  • Facility Address: 612 ST ANDREWS ROAD SUITE 2
    COLUMBIA, SC
    ZIP 29210
  • Facility Phone: 803 386-8684
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KIMBERLY SHIRK
  • NPI Number: 1477991941
  • Taxonomy: 1041C0700X - Social Worker

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CLIA Record

Field Name Field Value
CLIA Number 42D2158713
LAB Type Physician Office
Facility Name SOUTH CAROLINA CENTER FOR INTEGRATIVE MEDICINE
Street 612 ST ANDREWS ROAD SUITE 2
City COLUMBIA
State SC
ZIP 29210
Phone 803 386-8684
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/5/2024
Certificate Expiration Date 12/4/2026
Facility Type Physician Office
Lab Director KIMBERLY SHIRK

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