42D2202983 CLIA NUMBER - HOUSE CALLS - MD

Laboratory Demographics

  • CLIA Code: 42D2202983
  • Facility Name: HOUSE CALLS - MD
  • Facility Address: 1368 PENSHELL PLACE
    MT PLEASANT, SC
    ZIP 29464
  • Facility Phone: 843 501-2031
  • Facility Type: Other - MOBILE PRIMARY CARE PROVI
  • Facility Type: Waiver
  • Lab Director: STELA SUSAC-PAVIC
  • NPI Number: 1609273549
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 42D2202983
LAB Type Other - MOBILE PRIMARY CARE PROVI
Facility Name HOUSE CALLS - MD
Street 1368 PENSHELL PLACE
City MT PLEASANT
State SC
ZIP 29464
Phone 843 501-2031
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/2/2024
Certificate Expiration Date 12/1/2026
Facility Type Other - MOBILE PRIMARY CARE PROVI
Lab Director STELA SUSAC-PAVIC

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