42D2327357 CLIA NUMBER - COLUMBIA MEDICAL GROUP FOREST DRIVE

Laboratory Demographics

  • CLIA Code: 42D2327357
  • Facility Name: COLUMBIA MEDICAL GROUP FOREST DRIVE
  • Facility Address: 5115 FOREST DRIVE SUITE 100
    COLUMBIA, SC
    ZIP 29206
  • Facility Phone: 803 790-4700
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MATTHEW P. MAZZOLA
  • NPI Number: 1174506497
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 42D2327357
LAB Type Physician Office
Facility Name COLUMBIA MEDICAL GROUP FOREST DRIVE
Street 5115 FOREST DRIVE SUITE 100
City COLUMBIA
State SC
ZIP 29206
Phone 803 790-4700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/22/2025
Certificate Expiration Date 7/21/2027
Facility Type Physician Office
Lab Director MATTHEW P. MAZZOLA

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