42D2176045 CLIA NUMBER - THE PALMETTO PALACE MOBILE HEALTH UNIT

Laboratory Demographics

  • CLIA Code: 42D2176045
  • Facility Name: THE PALMETTO PALACE MOBILE HEALTH UNIT
  • Facility Address: 6265 DORCHESTER ROAD NORTH CHARLESTON FIRE STATION FIVE
    NORTH CHARLESTON, SC
    ZIP 29418
  • Facility Phone: 843 532-3169
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: YOULANDA C. GIBBS
  • NPI Number: 1962969154
  • Taxonomy: 261QR1300X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 42D2176045
LAB Type Mobile Laboratory
Facility Name THE PALMETTO PALACE MOBILE HEALTH UNIT
Street 6265 DORCHESTER ROAD NORTH CHARLESTON FIRE STATION FIVE
City NORTH CHARLESTON
State SC
ZIP 29418
Phone 843 532-3169
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/6/2023
Certificate Expiration Date 12/5/2025
Facility Type Mobile Laboratory
Lab Director YOULANDA C. GIBBS

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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