42D2327757 CLIA NUMBER - PRISMA HEALTH PRIMARY CARE - NORTHLAKE

Laboratory Demographics

  • CLIA Code: 42D2327757
  • Facility Name: PRISMA HEALTH PRIMARY CARE - NORTHLAKE
  • Facility Address: 8 JUSTICE LANE
    ANDERSON, SC
    ZIP 29621
  • Facility Phone: 864 760-6130
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JODY HUTSON
  • NPI Number: 1336039460
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 42D2327757
LAB Type Physician Office
Facility Name PRISMA HEALTH PRIMARY CARE - NORTHLAKE
Street 8 JUSTICE LANE
City ANDERSON
State SC
ZIP 29621
Phone 864 760-6130
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/29/2025
Certificate Expiration Date 7/28/2027
Facility Type Physician Office
Lab Director JODY HUTSON

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