42D2326362 CLIA NUMBER - PRISMA HEALTH MEDICAL PARK- NORTHEAST COLUMBIA

Laboratory Demographics

  • CLIA Code: 42D2326362
  • Facility Name: PRISMA HEALTH MEDICAL PARK- NORTHEAST COLUMBIA
  • Facility Address: 1120 ROBERT BRANCH PARKWAY
    COLUMBIA, SC
    ZIP 29229
  • Facility Phone: 513 883-4665
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KEVIN RYAN
  • NPI Number: 1902274095
  • Taxonomy: 273Y00000X - Rehabilitation Unit

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 42D2326362
LAB Type Physician Office
Facility Name PRISMA HEALTH MEDICAL PARK- NORTHEAST COLUMBIA
Street 1120 ROBERT BRANCH PARKWAY
City COLUMBIA
State SC
ZIP 29229
Phone 513 883-4665
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/2/2025
Certificate Expiration Date 7/1/2027
Facility Type Physician Office
Lab Director KEVIN RYAN

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