42D2162238 CLIA NUMBER - OAKBROOK INTERNAL MEDICINE

Laboratory Demographics

  • CLIA Code: 42D2162238
  • Facility Name: OAKBROOK INTERNAL MEDICINE
  • Facility Address: 1516 OLD TROLLEY ROAD SUITE 101
    SUMMERVILLE, SC
    ZIP 29485
  • Facility Phone: 843 203-9393
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. JEFFREY HERMAN
  • NPI Number: 1205910080
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 42D2162238
LAB Type Physician Office
Facility Name OAKBROOK INTERNAL MEDICINE
Street 1516 OLD TROLLEY ROAD SUITE 101
City SUMMERVILLE
State SC
ZIP 29485
Phone 843 203-9393
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/20/2025
Certificate Expiration Date 2/19/2027
Facility Type Physician Office
Lab Director DR. JEFFREY HERMAN

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