42D2265270 CLIA NUMBER - ONE SOURCE INTEGRATIVE MEDICINE

Laboratory Demographics

  • CLIA Code: 42D2265270
  • Facility Name: ONE SOURCE INTEGRATIVE MEDICINE
  • Facility Address: 1601-A WEST LUCAS STREET
    FLORENCE, SC
    ZIP 29501
  • Facility Phone: (843) 773-1444
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JENNIFER M. EVANS
  • NPI Number: 1912651647
  • Taxonomy: 208100000X - Physical Medicine & Rehabilitation

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CLIA Record

Field Name Field Value
CLIA Number 42D2265270
LAB Type Physician Office
Facility Name ONE SOURCE INTEGRATIVE MEDICINE
Street 1601-A WEST LUCAS STREET
City FLORENCE
State SC
ZIP 29501
Phone 8437731444
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/26/2024
Certificate Expiration Date 7/25/2026
Facility Type Physician Office
Lab Director JENNIFER M. EVANS

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This page was last updated on: 5/18/2026