42D2292830 CLIA NUMBER - PROACTIVE MD DOWNTOWN COLUMBIA HEALTH CENTER

Laboratory Demographics

  • CLIA Code: 42D2292830
  • Facility Name: PROACTIVE MD DOWNTOWN COLUMBIA HEALTH CENTER
  • Facility Address: 1715 BLANDING STREET
    COLUMBIA, SC
    ZIP 29201
  • Facility Phone: 803 999-5920
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: DR. MICHELLE TRAN
  • NPI Number: 1861266496
  • Taxonomy: 261QP2300X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 42D2292830
LAB Type Practitioner Other
Facility Name PROACTIVE MD DOWNTOWN COLUMBIA HEALTH CENTER
Street 1715 BLANDING STREET
City COLUMBIA
State SC
ZIP 29201
Phone 803 999-5920
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/31/2023
Certificate Expiration Date 10/30/2025
Facility Type Practitioner Other
Lab Director DR. MICHELLE TRAN

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