42D2321325 CLIA NUMBER - COASTAL WOUND CARE LLC

Laboratory Demographics

  • CLIA Code: 42D2321325
  • Facility Name: COASTAL WOUND CARE LLC
  • Facility Address: 5401 NETHERBY LANE UNIT 301
    NORTH CHARLESTON, SC
    ZIP 29420
  • Facility Phone: 843 554-9378
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TIMOTHY D. GREGORY
  • NPI Number: 1811681018
  • Taxonomy: 207P00000X - Emergency Medicine

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CLIA Record

Field Name Field Value
CLIA Number 42D2321325
LAB Type Physician Office
Facility Name COASTAL WOUND CARE LLC
Street 5401 NETHERBY LANE UNIT 301
City NORTH CHARLESTON
State SC
ZIP 29420
Phone 843 554-9378
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/2/2025
Certificate Expiration Date 4/1/2027
Facility Type Physician Office
Lab Director TIMOTHY D. GREGORY

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