42D2251996 CLIA NUMBER - MCLEOD FAMILY MEDICINE CAROLINA FOREST 2

Laboratory Demographics

  • CLIA Code: 42D2251996
  • Facility Name: MCLEOD FAMILY MEDICINE CAROLINA FOREST 2
  • Facility Address: 107 MCLEOD HEALTH BLVD, SUITE 102
    MYRTLE BEACH, SC
    ZIP 29579
  • Facility Phone: 843 646-8340
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JASON D. HARRAH
  • NPI Number: 1326594995
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 42D2251996
LAB Type Physician Office
Facility Name MCLEOD FAMILY MEDICINE CAROLINA FOREST 2
Street 107 MCLEOD HEALTH BLVD, SUITE 102
City MYRTLE BEACH
State SC
ZIP 29579
Phone 843 646-8340
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/21/2023
Certificate Expiration Date 12/20/2025
Facility Type Physician Office
Lab Director JASON D. HARRAH

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