42D2276964 CLIA NUMBER - COASTAL RECOVERY & WELLNESS CENTER DBA COASTAL RECOVERY

Laboratory Demographics

  • CLIA Code: 42D2276964
  • Facility Name: COASTAL RECOVERY & WELLNESS CENTER DBA COASTAL RECOVERY
  • Facility Address: 1113 44TH AVENUE N, SUITE 100
    MYRTLE BEACH, SC
    ZIP 29577
  • Facility Phone: 843 449-6261
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: MR. SPENCER W. JOSEY
  • NPI Number: 1386869337
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 42D2276964
LAB Type Comp. Outpatient Rehab Facility
Facility Name COASTAL RECOVERY & WELLNESS CENTER DBA COASTAL RECOVERY
Street 1113 44TH AVENUE N, SUITE 100
City MYRTLE BEACH
State SC
ZIP 29577
Phone 843 449-6261
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/17/2025
Certificate Expiration Date 2/16/2027
Facility Type Comp. Outpatient Rehab Facility
Lab Director MR. SPENCER W. JOSEY

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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