C & C MEDICAL LAB, LLC NPI 1003446378

Clinical Medical Laboratory in Greenville, SC

Organization Clinical Medical Laboratory CLIA Number 42D2165952 CLIA Certificate of Waiver

About C & C MEDICAL LAB, LLC

C & C Medical Lab, Llc is a provider established in Greenville, South Carolina specializing in clinical medical laboratory. The NPI number of C & C Medical Lab, Llc is 1003446378 and was assigned on January 2020. The practitioner's primary taxonomy code is 291U00000X. The provider is registered as an organization and their NPI record was last updated January 2020. The authorized official of this NPI record is Clytaya Chancellor Rma (Owner/ Operator)

The CLIA number of C & C Medical Lab, Llc is 42D2165952 registered as a "independent" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to C & C Medical Lab, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI

1003446378

Provider NameC & C MEDICAL LAB, LLC
Provider Location Address31 MEMORIAL MEDICAL DR GREENVILLE, SC 29605
Provider Mailing Address31 MEMORIAL MEDICAL DR GREENVILLE, SC 29605
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date01-24-2020
Last Update Date01-24-2020

Primary Taxonomy

Taxonomy Code291U00000X
ClassificationClinical Medical Laboratory
TypeLaboratories
Taxonomy Description(1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology.

Business Address

C & C MEDICAL LAB, LLC
31 MEMORIAL MEDICAL DR
GREENVILLE, SC
ZIP 29605
Phone: (864) 412-5051

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Mailing Address

C & C MEDICAL LAB, LLC
31 MEMORIAL MEDICAL DR
GREENVILLE, SC
ZIP 29605
Phone: (864) 412-5051

Authorized Official

Authorized Official Name CLYTAYA CHANCELLOR RMA
Authorized Official TitleOWNER/ OPERATOR
Authorized Official Phone(864) 395-0986

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1003446378 is:

CLIA Number42D2165952
Facility TypeINDEPENDENT
Certificate TypeCertificate of Waiver

Other Providers at the same location


The following provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1437597259 FRANK V CIOPPETTINI MD
Individual
Family Medicine31 MEMORIAL MEDICAL DR
GREENVILLE, SC 29605
(864) 932-3071

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.