42D2303680 CLIA NUMBER - CAROLINA PINES PAGELAND

Laboratory Demographics

  • CLIA Code: 42D2303680
  • Facility Name: CAROLINA PINES PAGELAND
  • Facility Address: 301 VAN LINGIE MUNGO BLVD
    PAGELAND, SC
    ZIP 29728
  • Facility Phone: 843 383-2764
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KWAME FOULKS
  • NPI Number: 1073842290
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 42D2303680
LAB Type Physician Office
Facility Name CAROLINA PINES PAGELAND
Street 301 VAN LINGIE MUNGO BLVD
City PAGELAND
State SC
ZIP 29728
Phone 843 383-2764
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/30/2024
Certificate Expiration Date 4/29/2026
Facility Type Physician Office
Lab Director KWAME FOULKS

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