42D2200696 CLIA NUMBER - THE EPICENTRE, LLC

Laboratory Demographics

  • CLIA Code: 42D2200696
  • Facility Name: THE EPICENTRE, LLC
  • Facility Address: 2048 CHARLIE HALL BLVD
    CHARLESTON, SC
    ZIP 29414
  • Facility Phone: 843 840-6010
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KENOSHA D. GLEATON
  • NPI Number: 1194363580
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 42D2200696
LAB Type Physician Office
Facility Name THE EPICENTRE, LLC
Street 2048 CHARLIE HALL BLVD
City CHARLESTON
State SC
ZIP 29414
Phone 843 840-6010
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/17/2024
Certificate Expiration Date 11/16/2026
Facility Type Physician Office
Lab Director KENOSHA D. GLEATON

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