42D2311505 CLIA NUMBER - TIDELANDS HEALTH UROLOGY AT MURRELLS INLET

Laboratory Demographics

  • CLIA Code: 42D2311505
  • Facility Name: TIDELANDS HEALTH UROLOGY AT MURRELLS INLET
  • Facility Address: 4040 HWY 17 UNIT 205
    MURRELLS INLET, SC
    ZIP 29576
  • Facility Phone: 843 652-8475
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GEOFFREY HABERMACHER
  • NPI Number: 1114780483
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 42D2311505
LAB Type Physician Office
Facility Name TIDELANDS HEALTH UROLOGY AT MURRELLS INLET
Street 4040 HWY 17 UNIT 205
City MURRELLS INLET
State SC
ZIP 29576
Phone 843 652-8475
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/24/2024
Certificate Expiration Date 9/23/2026
Facility Type Physician Office
Lab Director GEOFFREY HABERMACHER

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This page was last updated on: 3/20/2025