42D2299191 CLIA NUMBER - PROACTIVE MD FLORENCE

Laboratory Demographics

  • CLIA Code: 42D2299191
  • Facility Name: PROACTIVE MD FLORENCE
  • Facility Address: 1520 B AMERICAN DRIVE
    FLORENCE, SC
    ZIP 29505
  • Facility Phone: 843 713-8444
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: DR. MICHELLE T. TRAN
  • NPI Number: 1164283958
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 42D2299191
LAB Type Practitioner Other
Facility Name PROACTIVE MD FLORENCE
Street 1520 B AMERICAN DRIVE
City FLORENCE
State SC
ZIP 29505
Phone 843 713-8444
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/15/2024
Certificate Expiration Date 2/14/2026
Facility Type Practitioner Other
Lab Director DR. MICHELLE T. TRAN

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