42D2166445 CLIA NUMBER - CAROLINA CARDIOLOGY & VASCULAR ASSOCIATES, LLC

Laboratory Demographics

  • CLIA Code: 42D2166445
  • Facility Name: CAROLINA CARDIOLOGY & VASCULAR ASSOCIATES, LLC
  • Facility Address: 1 WELLNESS BLVD SUITE 106
    IRMO, SC
    ZIP 29063
  • Facility Phone: 803 888-2282
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DANIEL P. BOUKNIGHT
  • NPI Number: 1699261917
  • Taxonomy: 207X00000X - Orthopaedic Surgery

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CLIA Record

Field Name Field Value
CLIA Number 42D2166445
LAB Type Physician Office
Facility Name CAROLINA CARDIOLOGY & VASCULAR ASSOCIATES, LLC
Street 1 WELLNESS BLVD SUITE 106
City IRMO
State SC
ZIP 29063
Phone 803 888-2282
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/30/2024
Certificate Expiration Date 3/29/2026
Facility Type Physician Office
Lab Director DANIEL P. BOUKNIGHT

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