42D2261865 CLIA NUMBER - PRO CHIROPRACTIC AND PERFORMANCE

Laboratory Demographics

  • CLIA Code: 42D2261865
  • Facility Name: PRO CHIROPRACTIC AND PERFORMANCE
  • Facility Address: 150 PELHAM DRIVE
    COLUMBIA, SC
    ZIP 29209
  • Facility Phone: 803 227-3377
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: DR. PATRICK R. OTOLLE
  • NPI Number: 1346635752
  • Taxonomy: 261QR0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 42D2261865
LAB Type Practitioner Other
Facility Name PRO CHIROPRACTIC AND PERFORMANCE
Street 150 PELHAM DRIVE
City COLUMBIA
State SC
ZIP 29209
Phone 803 227-3377
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/7/2024
Certificate Expiration Date 6/6/2026
Facility Type Practitioner Other
Lab Director DR. PATRICK R. OTOLLE

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