42D2305169 CLIA NUMBER - PRISMA HEALTH IMAGING CENTER ORCHARD PARK

Laboratory Demographics

  • CLIA Code: 42D2305169
  • Facility Name: PRISMA HEALTH IMAGING CENTER ORCHARD PARK
  • Facility Address: 21 ORCHARD PARK DRIVE, SUITE A
    GREENVILLE, SC
    ZIP 29607
  • Facility Phone: 864 522-6370
  • Facility Type: Other - RETAIL IMAGING CENTER
  • Facility Type: Waiver
  • Lab Director: DONALD J. REYNOLDS
  • NPI Number: 1073366472
  • Taxonomy: 293D00000X - Physiological Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 42D2305169
LAB Type Other - RETAIL IMAGING CENTER
Facility Name PRISMA HEALTH IMAGING CENTER ORCHARD PARK
Street 21 ORCHARD PARK DRIVE, SUITE A
City GREENVILLE
State SC
ZIP 29607
Phone 864 522-6370
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/28/2024
Certificate Expiration Date 5/27/2026
Facility Type Other - RETAIL IMAGING CENTER
Lab Director DONALD J. REYNOLDS

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