42D2178069 CLIA NUMBER - LANTANA RECOVERY

Laboratory Demographics

  • CLIA Code: 42D2178069
  • Facility Name: LANTANA RECOVERY
  • Facility Address: 65 GADSEN STREET UNIT 6
    CHARLESTON, SC
    ZIP 29401
  • Facility Phone: 843 352-9982
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: WARREN H. PHILLIPS
  • NPI Number: 1801431069
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 42D2178069
LAB Type Comp. Outpatient Rehab Facility
Facility Name LANTANA RECOVERY
Street 65 GADSEN STREET UNIT 6
City CHARLESTON
State SC
ZIP 29401
Phone 843 352-9982
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/27/2024
Certificate Expiration Date 1/26/2026
Facility Type Comp. Outpatient Rehab Facility
Lab Director WARREN H. PHILLIPS

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