42D2210508 CLIA NUMBER - INDIGO HALL

Laboratory Demographics

  • CLIA Code: 42D2210508
  • Facility Name: INDIGO HALL
  • Facility Address: 509 STANDARD WAY
    JAMES ISLAND, SC
    ZIP 29412
  • Facility Phone: 843 406-4747
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: DR. STEVEN THOMAS
  • NPI Number: 1942847157
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 42D2210508
LAB Type Assisted Living Facility
Facility Name INDIGO HALL
Street 509 STANDARD WAY
City JAMES ISLAND
State SC
ZIP 29412
Phone 843 406-4747
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/21/2025
Certificate Expiration Date 1/20/2027
Facility Type Assisted Living Facility
Lab Director DR. STEVEN THOMAS

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