42D2250675 CLIA NUMBER - ELM PEDIATRICS

Laboratory Demographics

CLIA Number: 42D2250675

Facility Name: ELM PEDIATRICS

Facility Address:
800 WEST MAIN STREET
LAKE CITY, SC
ZIP 29560
Get Directions

Facility Phone Number: 843 977-7337

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1255009163

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	42D2250675
LAB Type	Physician Office
Facility Name	ELM PEDIATRICS
Street	800 WEST MAIN STREET
City	LAKE CITY
State	SC
ZIP	29560
Phone	843 977-7337
CertificateType	4
CertificateEffectiveDate	1/28/2024
CertificateExpirationDate	1/27/2026
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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