42D2208634 CLIA NUMBER - PRISMA HEALTH PACE SENIOR CARE-SHANDON

Laboratory Demographics

  • CLIA Code: 42D2208634
  • Facility Name: PRISMA HEALTH PACE SENIOR CARE-SHANDON
  • Facility Address: 1100 SHIRLEY STREET
    COLUMBIA, SC
    ZIP 29205
  • Facility Phone: 803 252-1979
  • Facility Type: Other - PACE CENTER
  • Facility Type: Waiver
  • Lab Director: LAURIE D. THERIOT ROLEY
  • NPI Number: 1801241971
  • Taxonomy: 311ZA0620X - Custodial Care Facility

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 42D2208634
LAB Type Other - PACE CENTER
Facility Name PRISMA HEALTH PACE SENIOR CARE-SHANDON
Street 1100 SHIRLEY STREET
City COLUMBIA
State SC
ZIP 29205
Phone 803 252-1979
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/7/2025
Certificate Expiration Date 1/6/2027
Facility Type Other - PACE CENTER
Lab Director LAURIE D. THERIOT ROLEY

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