42D2161446 CLIA NUMBER - CMC PEDIATRICS - CONWAY

Laboratory Demographics

  • CLIA Code: 42D2161446
  • Facility Name: CMC PEDIATRICS - CONWAY
  • Facility Address: 124 A PROFESSIONAL PARK DR
    CONWAY, SC
    ZIP 29526
  • Facility Phone: 843 234-5139
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. WILLIAM NICHOLS
  • NPI Number: 1750844510
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 42D2161446
LAB Type Physician Office
Facility Name CMC PEDIATRICS - CONWAY
Street 124 A PROFESSIONAL PARK DR
City CONWAY
State SC
ZIP 29526
Phone 843 234-5139
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/1/2025
Certificate Expiration Date 1/31/2027
Facility Type Physician Office
Lab Director DR. WILLIAM NICHOLS

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