42D2321603 CLIA NUMBER - TIDELANDS HEALTH UROLOGY AT GEORGETOWN

Laboratory Demographics

  • CLIA Code: 42D2321603
  • Facility Name: TIDELANDS HEALTH UROLOGY AT GEORGETOWN
  • Facility Address: 606 BLACK RIVER RD
    GEORGETOWN, SC
    ZIP 29440
  • Facility Phone: 843 652-8475
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GEOFFREY HABERMACHER
  • NPI Number: 1114780483
  • Taxonomy: 208800000X - Urology

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 42D2321603
LAB Type Physician Office
Facility Name TIDELANDS HEALTH UROLOGY AT GEORGETOWN
Street 606 BLACK RIVER RD
City GEORGETOWN
State SC
ZIP 29440
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 4/7/2025
Certificate Expiration Date 4/6/2027
Facility Type Physician Office
Lab Director GEOFFREY HABERMACHER

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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