42D2266508 CLIA NUMBER - FAST TRAC AMBULANCE SERVICE

Laboratory Demographics

  • CLIA Code: 42D2266508
  • Facility Name: FAST TRAC AMBULANCE SERVICE
  • Facility Address: 201 COLUMBIA MALL BLVD, SUITE 121
    COLUMBIA, SC
    ZIP 29223
  • Facility Phone: 803 419-8486
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: TREVIS L. RUTLEDGE
  • NPI Number: 1710316468
  • Taxonomy: 3416L0300X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 42D2266508
LAB Type Ambulance
Facility Name FAST TRAC AMBULANCE SERVICE
Street 201 COLUMBIA MALL BLVD, SUITE 121
City COLUMBIA
State SC
ZIP 29223
Phone 803 419-8486
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/11/2024
Certificate Expiration Date 8/10/2026
Facility Type Ambulance
Lab Director TREVIS L. RUTLEDGE

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