42D2298455 CLIA NUMBER - SELF REGIONAL HEALTHCARE ADAVNCED CARDIOLOGY- ABBEVILLE

Laboratory Demographics

  • CLIA Code: 42D2298455
  • Facility Name: SELF REGIONAL HEALTHCARE ADAVNCED CARDIOLOGY- ABBEVILLE
  • Facility Address: 905 W GREENWOOD STREET
    ABBEVILLE, SC
    ZIP 29620
  • Facility Phone: 864 227-6818
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. ANGELA LOPEZ DE LEON
  • NPI Number: 1215246350
  • Taxonomy: 207RC0000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 42D2298455
LAB Type Physician Office
Facility Name SELF REGIONAL HEALTHCARE ADAVNCED CARDIOLOGY- ABBEVILLE
Street 905 W GREENWOOD STREET
City ABBEVILLE
State SC
ZIP 29620
Phone 864 227-6818
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/2/2024
Certificate Expiration Date 2/1/2026
Facility Type Physician Office
Lab Director DR. ANGELA LOPEZ DE LEON

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