42D2281864 CLIA NUMBER - CMC PRIMARY CARE CHURCH STREET

Laboratory Demographics

  • CLIA Code: 42D2281864
  • Facility Name: CMC PRIMARY CARE CHURCH STREET
  • Facility Address: 2701 CHURCH STRRET, SUITE A
    CONWAY, SC
    ZIP 29526
  • Facility Phone: 843 365-0295
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. MICHAEL M. FROST
  • NPI Number: 1073219325
  • Taxonomy: 207R00000X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 42D2281864
LAB Type Physician Office
Facility Name CMC PRIMARY CARE CHURCH STREET
Street 2701 CHURCH STRRET, SUITE A
City CONWAY
State SC
ZIP 29526
Phone 843 365-0295
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/12/2025
Certificate Expiration Date 5/11/2027
Facility Type Physician Office
Lab Director DR. MICHAEL M. FROST

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