42D2309432 CLIA NUMBER - CMC DERMATOLOGY AND PRIMARY CARE GRANDE DUNES

Laboratory Demographics

  • CLIA Code: 42D2309432
  • Facility Name: CMC DERMATOLOGY AND PRIMARY CARE GRANDE DUNES
  • Facility Address: 1100 62ND AVENUE NORTH, SUITE B
    MYRTLE BEACH, SC
    ZIP 29572
  • Facility Phone: 843 839-0957
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: YUMENG LI
  • NPI Number: 1366191702
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 42D2309432
LAB Type Physician Office
Facility Name CMC DERMATOLOGY AND PRIMARY CARE GRANDE DUNES
Street 1100 62ND AVENUE NORTH, SUITE B
City MYRTLE BEACH
State SC
ZIP 29572
Phone 843 839-0957
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 8/14/2024
Certificate Expiration Date 8/13/2026
Facility Type Physician Office
Lab Director YUMENG LI

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