42D2311875 CLIA NUMBER - CMC PRIMARY CARE COASTAL CAROLINA UNIVERSITY

Laboratory Demographics

  • CLIA Code: 42D2311875
  • Facility Name: CMC PRIMARY CARE COASTAL CAROLINA UNIVERSITY
  • Facility Address: 251 UNIVERSITY BLVD SUITE A
    CONWAY, SC
    ZIP 29526
  • Facility Phone: 843 347-0524
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARIE LIVIGNI
  • NPI Number: 1306689237
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 42D2311875
LAB Type Physician Office
Facility Name CMC PRIMARY CARE COASTAL CAROLINA UNIVERSITY
Street 251 UNIVERSITY BLVD SUITE A
City CONWAY
State SC
ZIP 29526
Phone 843 347-0524
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/1/2024
Certificate Expiration Date 9/30/2026
Facility Type Physician Office
Lab Director MARIE LIVIGNI

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