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EAU CLAIRE COOPERATIVE HEALTH CENTER, INC.
NPI 1053622050
Clinic/Center - Federally Qualified Health Center (FQHC) in Columbia, SC

Active since June 24, 2010CLIA 42D0911761 · Microscopy
1228 HARDEN ST, STE.C, COLUMBIA, SC 29204(803) 748-1181(803) 748-1185 Get Directions Write a Review

NPPES record last updated: June 24, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Feb 3, 2022, Dec 16, 2016, Oct 20, 2016 and 1 more (4 updates tracked since 2016).

About Eau Claire Cooperative Health Center, Inc. NPPES

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

EAU CLAIRE COOPERATIVE HEALTH CENTER, INC. (NPI 1053622050), doing business as Waverly Family Practice, is a healthcare organization registered as a federally qualified health center (fqhc) in Columbia, South Carolina and active in the NPI registry since June 2010. The organization holds a CLIA Microscopy certificate valid through March 31, 2028 and lists Kimberly Tilley, Credentialing Manager, as its authorized official.

NPPES Registry Identity

NPI1053622050
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameEAU CLAIRE COOPERATIVE HEALTH CENTER, INC.
Location Address1228 HARDEN ST, STE.CColumbia, SC 29204-1800
Mailing AddressPo Box 3788Columbia, SC 29230-3788 · (803) 733-5969 · Fax (803) 753-5591
Phone(803) 748-1181
Fax(803) 748-1185
Organization SubpartNo
Authorized OfficialKimberly TilleyCredentialing Manager · (804) 306-1203
Enumeration DateJune 24, 2010
Last NPPES UpdateJune 24, 20264 updates tracked since enumeration
NPPES CertifiedJune 24, 2026
✔ NPI 1053622050 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
1228 HARDEN ST, Columbia, SC 29204
Open in Google Maps ↗

Other Names 1

Doing Business AsWaverly Family Practice

Other Identifiers 3

MedicaidCBP018SC
MedicaidFQC031SC
MedicaidFQC164SC

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include First Choice Next, Molina Healthcare.Insurance ›

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 for Provider-Performed Microscopy Procedures (PPMP) 42D0911761

Waverly Family Practice · Columbia, SC
Active · expires Mar 31, 2028
CLIA Number42D0911761
Laboratory TypeCommunity Clinic
Certificate Effective DateApril 1, 2026
Certificate Expiration DateMarch 31, 2028
Laboratory DirectorDr. Tabitha Garner
Laboratory Phone(803) 748-1181
Laboratory LocationWaverly Family Practice1228 Harden Street Suite C, Columbia, SC 29204
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CAROLINA OB/GYN GROUP, LLC
Obstetrics & Gynecology
1228 HARDEN ST
COLUMBIA, SC 29204
Richland County (803) 744-0550
MS. KESHA WATKINS NP-C
Nurse Practitioner (Family)
1228 HARDEN ST
COLUMBIA, SC 29204
Richland County (803) 733-5969
PRISHAL CHETTY HOLLOWAY M.D.
Pediatrics
1228 HARDEN ST
COLUMBIA, SC 29204
Richland County (803) 733-5969
TRENTEN A PRIOLEAU DPM
Podiatrist
1228 HARDEN ST
COLUMBIA, SC 29204
Richland County (803) 744-0540
DR. ABOAGYE AGYENIM - BOATENG MD
Obstetrics & Gynecology
1228 HARDEN ST
COLUMBIA, SC 29204
Richland County (803) 744-0550
EAU CLAIRE COOPERATIVE HEALTH CENTER ,INC.
Clinic/Center (Federally Qualified Health Center (FQHC))
1228 HARDEN ST, STE.B
COLUMBIA, SC 29204
Richland County (803) 744-0540
EAU CLAIRE COOPERATIVE HEALTH CENTER, INC.
Clinic/Center (Federally Qualified Health Center (FQHC))
1228 HARDEN ST
COLUMBIA, SC 29204
Richland County (803) 733-5969
FIVE POINTS COOPERATIVE PHARMACY
Pharmacy (Community/Retail Pharmacy)
1228 HARDEN ST
COLUMBIA, SC 29204
Richland County (803) 748-0482

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 Eau Claire Cooperative Health Center, Inc.'s NPI number?

The NPI number for Eau Claire Cooperative Health Center, Inc. is 1053622050. It was assigned to this organization in the NPPES registry on June 24, 2010. The provider is doing business as Waverly Family Practice.

Where is Eau Claire Cooperative Health Center, Inc. located?

Eau Claire Cooperative Health Center, Inc. is located at 1228 Harden St Ste.C, Columbia, SC 29204. The listed phone number is (803) 748-1181.

What is Eau Claire Cooperative Health Center, Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

Does Eau Claire Cooperative Health Center, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 42D0911761) is associated with this NPI, valid through March 31, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Eau Claire Cooperative Health Center, Inc. accept?

Health plans from First Choice Next and Molina Healthcare list Eau Claire Cooperative Health Center, Inc. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Eau Claire Cooperative Health Center, Inc. was last updated on June 24, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.