42D2200227 CLIA NUMBER - LIBERTY DOCTORS, LLC DBA VIDUYA FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 42D2200227
  • Facility Name: LIBERTY DOCTORS, LLC DBA VIDUYA FAMILY PRACTICE
  • Facility Address: 2175 ASHLEY PHOSPHATE RD SUITE D
    NORTH CHARLESTON, SC
    ZIP 29406
  • Facility Phone: 843 442-5908
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SHERRY VIDUYA
  • NPI Number: 1760083562
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 42D2200227
LAB Type Physician Office
Facility Name LIBERTY DOCTORS, LLC DBA VIDUYA FAMILY PRACTICE
Street 2175 ASHLEY PHOSPHATE RD SUITE D
City NORTH CHARLESTON
State SC
ZIP 29406
Phone 843 442-5908
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/13/2024
Certificate Expiration Date 11/12/2026
Facility Type Physician Office
Lab Director SHERRY VIDUYA

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