42D2254096 CLIA NUMBER - NOVANT HEALTH NEW RIVER UROLOGY

Laboratory Demographics

  • CLIA Code: 42D2254096
  • Facility Name: NOVANT HEALTH NEW RIVER UROLOGY
  • Facility Address: 75 BAYLOR DRIVE, SUITE 205
    BLUFFTON, SC
    ZIP 29910
  • Facility Phone: 843 706-2255
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ERIC S. GWYNN
  • NPI Number: 1164488383
  • Taxonomy: 111N00000X - Chiropractor

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CLIA Record

Field Name Field Value
CLIA Number 42D2254096
LAB Type Physician Office
Facility Name NOVANT HEALTH NEW RIVER UROLOGY
Street 75 BAYLOR DRIVE, SUITE 205
City BLUFFTON
State SC
ZIP 29910
Phone 843 706-2255
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 2/29/2024
Certificate Expiration Date 2/27/2026
Facility Type Physician Office
Lab Director ERIC S. GWYNN

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