42D2191645 CLIA NUMBER - LA BELLA, MD

Laboratory Demographics

  • CLIA Code: 42D2191645
  • Facility Name: LA BELLA, MD
  • Facility Address: 4600 OLEANDER DRIVE SUITE 1A
    MYRTLE BEACH, SC
    ZIP 29577
  • Facility Phone: 843 957-5099
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JAN SOLOMON
  • NPI Number: 1063045565
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 42D2191645
LAB Type Physician Office
Facility Name LA BELLA, MD
Street 4600 OLEANDER DRIVE SUITE 1A
City MYRTLE BEACH
State SC
ZIP 29577
Phone 843 957-5099
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/31/2024
Certificate Expiration Date 8/30/2026
Facility Type Physician Office
Lab Director JAN SOLOMON

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