42D2256433 CLIA NUMBER - BROAD RIVER WELLNESS, LLC

Laboratory Demographics

  • CLIA Code: 42D2256433
  • Facility Name: BROAD RIVER WELLNESS, LLC
  • Facility Address: 4027 WOODLAWN STREET
    SHARON, SC
    ZIP 29742
  • Facility Phone: 803 627-0220
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: MS. REBECCA R. BAKER
  • NPI Number: 1992454532
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 42D2256433
LAB Type Community Clinic
Facility Name BROAD RIVER WELLNESS, LLC
Street 4027 WOODLAWN STREET
City SHARON
State SC
ZIP 29742
Phone 803 627-0220
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/24/2024
Certificate Expiration Date 3/23/2026
Facility Type Community Clinic
Lab Director MS. REBECCA R. BAKER

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