42D2212749 CLIA NUMBER - OAK STREET HEALTH-GREENVILLE

Laboratory Demographics

CLIA Number: 42D2212749

Facility Name: OAK STREET HEALTH-GREENVILLE

Facility Address:
6119 WHITE HORSE RD, SUITE 14
GREENVILLE, SC
ZIP 29611
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Facility Phone Number: 844 808-8262

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1023614914

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	42D2212749
LAB Type	Physician Office
Facility Name	OAK STREET HEALTH-GREENVILLE
Street	6119 WHITE HORSE RD, SUITE 14
City	GREENVILLE
State	SC
ZIP	29611
Phone	844 808-8262
CertificateType	4
CertificateEffectiveDate	2/7/2023
CertificateExpirationDate	2/6/2025
FacilityType	Waiver

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