42D2292831 CLIA NUMBER - PROACTIVE MD CONWAY HEALTH CENTER

Laboratory Demographics

  • CLIA Code: 42D2292831
  • Facility Name: PROACTIVE MD CONWAY HEALTH CENTER
  • Facility Address: 903 BELL STREET
    CONWAY, SC
    ZIP 29526
  • Facility Phone: 843 438-2308
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: DR. MICHELLE TRAN
  • NPI Number: 1437923059
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 42D2292831
LAB Type Practitioner Other
Facility Name PROACTIVE MD CONWAY HEALTH CENTER
Street 903 BELL STREET
City CONWAY
State SC
ZIP 29526
Phone 843 438-2308
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

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