42D2299009 CLIA NUMBER - PRISMA HEALTH PEDIATRIC MULTISPECIALTY

Laboratory Demographics

CLIA Number: 42D2299009

Facility Name: PRISMA HEALTH PEDIATRIC MULTISPECIALTY

Facility Address:
9 RICHLAND MEDICAL PARK, SUITE 450
COLUMBIA, SC
ZIP 29203
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Facility Phone Number: 803 434-7995

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1285678078

Taxonomy: 2080P0208X - Pediatrics
A pediatrician trained to care for children in the diagnosis, treatment and prevention of infectious diseases. This specialist can apply specific knowledge to affect a better outcome for pediatric infections with complicated courses, underlying diseases that predispose to unusual or severe infections, unclear diagnoses, uncommon diseases and complex or investigational treatments.

CLIA Record

Field Name	Field Value
CLIA Number	42D2299009
LAB Type	Physician Office
Facility Name	PRISMA HEALTH PEDIATRIC MULTISPECIALTY
Street	9 RICHLAND MEDICAL PARK, SUITE 450
City	COLUMBIA
State	SC
ZIP	29203
Phone	803 434-7995
CertificateType	4
CertificateEffectiveDate	2/13/2024
CertificateExpirationDate	2/12/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024