1. Home
  2. Directory
  3. South Carolina
  4. Myrtle Beach
  5. Clinic Center
  6. NPI Profile

CAROLINA FOREST IMAGING CENTER LLC
NPI 1063603587
Clinic/Center - Radiology in Myrtle Beach, SC

Active since August 08, 2007CLIA 42D1079932 · Waiver
199 VILLAGE CENTER BLVD, SUITE 110, MYRTLE BEACH, SC 29579(843) 236-7878(843) 236-6406 Get Directions Write a Review

NPPES record last updated: November 30, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Carolina Forest Imaging Center Llc NPPES

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

CAROLINA FOREST IMAGING CENTER LLC (NPI 1063603587) is a healthcare organization registered as a radiology in Myrtle Beach, South Carolina and active in the NPI registry since August 2007. The organization holds a CLIA Waiver certificate valid through February 10, 2028 and lists Lavelle R Hardin, Credentialing Coordinator, as its authorized official.

NPPES Registry Identity

NPI1063603587
Entity TypeOrganization
Primary Taxonomy261QR0200X
Legal Business NameCAROLINA FOREST IMAGING CENTER LLC
Location Address199 VILLAGE CENTER BLVD, SUITE 110Myrtle Beach, SC 29579
Mailing Address199 Village Center Blvd, Suite 110Myrtle Beach, SC 29579 · (843) 236-7878 · Fax (843) 236-6406
Phone(843) 236-7878
Fax(843) 236-6406
Organization SubpartNo
Authorized OfficialLavelle R HardinCredentialing Coordinator · (615) 344-8203
Enumeration DateAugust 8, 2007
Last NPPES UpdateNovember 30, 2007
✔ NPI 1063603587 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinic/Center · RadiologyAmbulatory Health Care Facilities
Taxonomy Code261QR0200X
Also ListedClinic/Center · Magnetic Resonance Imaging (MRI)Taxonomy 261QM1200X
Also ListedClinic/Center · Radiology, MammographyTaxonomy 261QR0206X
199 VILLAGE CENTER BLVD, Myrtle Beach, SC 29579
Open in Google Maps ↗

Other Identifiers 1

MedicaidGP4758SC

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 42D1079932

Carolina Forest Imaging Center · Myrtle Beach, SC
Active · expires Feb 10, 2028
CLIA Number42D1079932
Laboratory TypeAncillary Testing Site In Health Care Center
Certificate Effective DateFebruary 11, 2026
Certificate Expiration DateFebruary 10, 2028
Laboratory DirectorDr. Pablo Souza
Laboratory Phone(843) 236-7878
Laboratory LocationCarolina Forest Imaging Center199 Village Center Blvd, Suite 110, Myrtle Beach, SC 29579
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

ATLANTIC UROLOGY CLINIC LLC
Surgery
199 VILLAGE CENTER BLVD, SUITE 100
MYRTLE BEACH, SC 29579
Horry County (843) 236-4330
ATLANTIC UROLOGY CLINICS LLC
Obstetrics & Gynecology (Gynecologic Oncology)
199 VILLAGE CENTER BLVD, SUITE 100
MYRTLE BEACH, SC 29579
Horry County (239) 931-7342
CAROLINA FOREST IMAGING CENTER LLC
Radiology (Diagnostic Radiology)
199 VILLAGE CENTER BLVD, SUITE 110
MYRTLE BEACH, SC 29579
Horry County (843) 236-7878

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 Carolina Forest Imaging Center LLC's NPI number?

The NPI number for Carolina Forest Imaging Center LLC is 1063603587. It was assigned to this organization in the NPPES registry on August 8, 2007.

Where is Carolina Forest Imaging Center LLC located?

Carolina Forest Imaging Center LLC is located at 199 Village Center Blvd Suite 110, Myrtle Beach, SC 29579. The listed phone number is (843) 236-7878.

What is Carolina Forest Imaging Center LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Radiology, with taxonomy code 261QR0200X.

Does Carolina Forest Imaging Center LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 42D1079932) is associated with this NPI, valid through February 10, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Carolina Forest Imaging Center LLC was last updated on November 30, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.