42D2202983 CLIA NUMBER - HOUSE CALLS - MD

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Laboratory Demographics

CLIA Number: 42D2202983

Facility Name: HOUSE CALLS - MD

Facility Address:
1368 PENSHELL PLACE
MT PLEASANT, SC
ZIP 29464
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Facility Phone Number: 843 501-2031

Facility Type: Other - MOBILE PRIMARY CARE PROVI

Certificate Type: Waiver

NPI Number: 1609273549

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

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
CertificateType	4
CertificateEffectiveDate	12/2/2022
CertificateExpirationDate	12/1/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024