42D2225069 CLIA NUMBER - GENTLE STICKS MOBILE PHLEBOTOMY, LLC

Laboratory Demographics

  • CLIA Code: 42D2225069
  • Facility Name: GENTLE STICKS MOBILE PHLEBOTOMY, LLC
  • Facility Address: 4371 CHARLOTTE HWY, SUITE 22
    LAKE WYLIE, SC
    ZIP 29710
  • Facility Phone: 803 589-7999
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: KANNESHA COLEMAN
  • NPI Number: 1396362414
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 42D2225069
LAB Type Mobile Laboratory
Facility Name GENTLE STICKS MOBILE PHLEBOTOMY, LLC
Street 4371 CHARLOTTE HWY, SUITE 22
City LAKE WYLIE
State SC
ZIP 29710
Phone 803 589-7999
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/18/2025
Certificate Expiration Date 5/17/2027
Facility Type Mobile Laboratory
Lab Director KANNESHA COLEMAN

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