42D2321682 CLIA NUMBER - PALMETTO MT PLEASANT BEHAVIORAL HEALTH LLC

Laboratory Demographics

  • CLIA Code: 42D2321682
  • Facility Name: PALMETTO MT PLEASANT BEHAVIORAL HEALTH LLC
  • Facility Address: 676 WANDO PARK BLVD
    MT PLEASANT, SC
    ZIP 29464
  • Facility Phone: 854 260-8220
  • Facility Type: Other - SUB RESIDENTIAL
  • Facility Type: Waiver
  • Lab Director: ANTHONY CARBONE
  • NPI Number: 1184870206
  • Taxonomy: 235Z00000X - Speech-Language Pathologist

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CLIA Record

Field Name Field Value
CLIA Number 42D2321682
LAB Type Other - SUB RESIDENTIAL
Facility Name PALMETTO MT PLEASANT BEHAVIORAL HEALTH LLC
Street 676 WANDO PARK BLVD
City MT PLEASANT
State SC
ZIP 29464
Phone 854 260-8220
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/8/2025
Certificate Expiration Date 4/7/2027
Facility Type Other - SUB RESIDENTIAL
Lab Director ANTHONY CARBONE

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