42D2263854 CLIA NUMBER - SOUTH CAROLINA PLASTIC SURGERY

Laboratory Demographics

  • CLIA Code: 42D2263854
  • Facility Name: SOUTH CAROLINA PLASTIC SURGERY
  • Facility Address: 1721 EBENEZER ROAD, SUITE 115
    ROCK HILL, SC
    ZIP 29732
  • Facility Phone: 704 741-9970
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. PAUL DIEGIDIO
  • NPI Number: 1548454754
  • Taxonomy: 207P00000X - Emergency Medicine

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CLIA Record

Field Name Field Value
CLIA Number 42D2263854
LAB Type Physician Office
Facility Name SOUTH CAROLINA PLASTIC SURGERY
Street 1721 EBENEZER ROAD, SUITE 115
City ROCK HILL
State SC
ZIP 29732
Phone 704 741-9970
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/6/2024
Certificate Expiration Date 7/5/2026
Facility Type Physician Office
Lab Director DR. PAUL DIEGIDIO

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