PREMIER SURGERY CENTER OF THE CAROLINAS, LLC
NPI 1023839438
Clinic/Center - Ambulatory Surgical in Indian Land, SC

Q: What is Premier Surgery Center Of The Carolinas, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

Active since October 18, 2024CLIA 42D2315476 · Waiver

1170 EDGEWATER CORPORATE PKWY STE 106, INDIAN LAND, SC 29707(803) 239-4504 Get Directions Write a Review

NPPES record last updated: June 30, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 30, 2025, Nov 5, 2024 (2 updates tracked since 2024).

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About Premier Surgery Center Of The Carolinas, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PREMIER SURGERY CENTER OF THE CAROLINAS, LLC (NPI 1023839438) is a healthcare organization registered as an ambulatory surgical in Indian Land, South Carolina and active in the NPI registry since October 2024. The organization holds a CLIA Waiver certificate valid through December 12, 2026 and lists Ivan Mac, Founding Member, as its authorized official.

NPPES Registry Identity

NPI1023839438

Entity TypeOrganization

Primary Taxonomy261QA1903X

Legal Business NamePREMIER SURGERY CENTER OF THE CAROLINAS, LLC

Location Address1170 EDGEWATER CORPORATE PKWY STE 106Indian Land, SC 29707-4607

Mailing Address4101 Campus Ridge RdMatthews, NC 28105-5077

Phone(803) 239-4504

Organization SubpartNo

Authorized OfficialIvan MacFounding Member · (704) 254-9099

Enumeration DateOctober 18, 2024

Last NPPES UpdateJune 30, 20252 updates tracked since enumeration

NPPES CertifiedJune 30, 2025

✔ NPI 1023839438 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities

Taxonomy Code261QA1903X

Also ListedOphthalmologyTaxonomy 207W00000X

1170 EDGEWATER CORPORATE PKWY STE 106, Indian Land, SC 29707

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 42D2315476

Premier Surgery Center Of The Carolinas LLC · Fort Mill, SC

Active · expires Dec 12, 2026

CLIA Number42D2315476

Laboratory TypeAmbulatory Surgery Center

Certificate Effective DateDecember 13, 2024

Certificate Expiration DateDecember 12, 2026

Laboratory DirectorMac Ivan

Laboratory Phone(914) 980-0738

Laboratory LocationPremier Surgery Center Of The Carolinas LLC1170 Edgewater Corporate Parkway, Fort Mill, SC 29707

CLIA data matches this NPI record on: Name

This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Premier Surgery Center Of The Carolinas, LLC's NPI number?

The NPI number for Premier Surgery Center Of The Carolinas, LLC is 1023839438. It was assigned to this organization in the NPPES registry on October 18, 2024.

Where is Premier Surgery Center Of The Carolinas, LLC located?

Premier Surgery Center Of The Carolinas, LLC is located at 1170 Edgewater Corporate Pkwy Ste 106, Indian Land, SC 29707. The listed phone number is (803) 239-4504.

What is Premier Surgery Center Of The Carolinas, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

Does Premier Surgery Center Of The Carolinas, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 42D2315476) is associated with this NPI, valid through December 12, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Premier Surgery Center Of The Carolinas, LLC was last updated on June 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.