42D2321383 CLIA NUMBER - COASTLINE AMBULANCE LLC

Laboratory Demographics

  • CLIA Code: 42D2321383
  • Facility Name: COASTLINE AMBULANCE LLC
  • Facility Address: 1400 CHURCH STREET SUITE 300 B
    CONWAY, SC
    ZIP 29526
  • Facility Phone: 843 356-2326
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: BRENT M. JOHNS
  • NPI Number: 1275320855
  • Taxonomy: 3416L0300X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 42D2321383
LAB Type Ambulance
Facility Name COASTLINE AMBULANCE LLC
Street 1400 CHURCH STREET SUITE 300 B
City CONWAY
State SC
ZIP 29526
Phone 843 356-2326
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/3/2025
Certificate Expiration Date 4/2/2027
Facility Type Ambulance
Lab Director BRENT M. JOHNS

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