42D2179416 CLIA NUMBER - PALMETTO ADULT AND CHILDREN'S UROLOGY

Laboratory Demographics

  • CLIA Code: 42D2179416
  • Facility Name: PALMETTO ADULT AND CHILDREN'S UROLOGY
  • Facility Address: 5500 FRONT STREET, STE 250
    SUMMERVILLE, SC
    ZIP 29486
  • Facility Phone: 843 797-6600
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. NELSON R. PLOCH
  • NPI Number: 1568405926
  • Taxonomy: 207Q00000X - Family Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 42D2179416
LAB Type Physician Office
Facility Name PALMETTO ADULT AND CHILDREN'S UROLOGY
Street 5500 FRONT STREET, STE 250
City SUMMERVILLE
State SC
ZIP 29486
Phone 843 797-6600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/24/2024
Certificate Expiration Date 2/23/2026
Facility Type Physician Office
Lab Director DR. NELSON R. PLOCH

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