42D2177576 CLIA NUMBER - ELITE GYNECOLOGY

Laboratory Demographics

  • CLIA Code: 42D2177576
  • Facility Name: ELITE GYNECOLOGY
  • Facility Address: 1 WELLNESS BLVD, SUITE 102
    IRMO, SC
    ZIP 29063
  • Facility Phone: 803 638-3946
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MICHELLE GEE
  • NPI Number: 1215598230
  • Taxonomy: 207VG0400X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 42D2177576
LAB Type Physician Office
Facility Name ELITE GYNECOLOGY
Street 1 WELLNESS BLVD, SUITE 102
City IRMO
State SC
ZIP 29063
Phone 803 638-3946
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 1/14/2024
Certificate Expiration Date 1/13/2026
Facility Type Physician Office
Lab Director MICHELLE GEE

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