42D2256176 CLIA NUMBER - CENTER FOR SUCCESS IN AGING-ROLLING GREEN VILLAGE

Laboratory Demographics

  • CLIA Code: 42D2256176
  • Facility Name: CENTER FOR SUCCESS IN AGING-ROLLING GREEN VILLAGE
  • Facility Address: 1 HOKE SMITH BOULEVARD
    GREENVILLE, SC
    ZIP 29615
  • Facility Phone: 864 454-8120
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: DR. LAURIE M. THERIOT ROLEY
  • NPI Number: 1174500904
  • Taxonomy: 261QA1903X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 42D2256176
LAB Type Community Clinic
Facility Name CENTER FOR SUCCESS IN AGING-ROLLING GREEN VILLAGE
Street 1 HOKE SMITH BOULEVARD
City GREENVILLE
State SC
ZIP 29615
Phone 864 454-8120
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/22/2024
Certificate Expiration Date 3/21/2026
Facility Type Community Clinic
Lab Director DR. LAURIE M. THERIOT ROLEY

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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