42D2325937 CLIA NUMBER - SU SURGICAL ASSOCIATES LLC

Laboratory Demographics

  • CLIA Code: 42D2325937
  • Facility Name: SU SURGICAL ASSOCIATES LLC
  • Facility Address: 109 MIDLANDS COURT
    WEST COLUMBIA, SC
    ZIP 29169
  • Facility Phone: 803 457-7000
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: ANDREA M. PEZZELLA
  • NPI Number: 1548055585
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 42D2325937
LAB Type Ambulatory Surgery Center
Facility Name SU SURGICAL ASSOCIATES LLC
Street 109 MIDLANDS COURT
City WEST COLUMBIA
State SC
ZIP 29169
Phone 803 457-7000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/24/2025
Certificate Expiration Date 6/23/2027
Facility Type Ambulatory Surgery Center
Lab Director ANDREA M. PEZZELLA

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