PREMISE HEALTH OF SOUTH CAROLINA MEDICAL PC
NPI 1265105258
Clinic/Center - Multi-Specialty in Myrtle Beach, SC
- Organization
- Clinic/Center
- Multi-Specialty
- CLIA Number: 42D2008406
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 06-09-2028
About PREMISE HEALTH OF SOUTH CAROLINA MEDICAL PC
This page provides the complete NPI Profile along with additional information for Premise Health Of South Carolina Medical Pc, a provider established in Myrtle Beach, South Carolina operating as a Clinic/center, focusing in multi-specialty . The healthcare provider is registered in the NPI registry with number 1265105258 assigned on July 2021. The practitioner's primary taxonomy code is 261QM1300X. The provider is registered as an organization and their NPI record was last updated February 2026. The authorized official of this NPI record is Edward William Schwartz (President)
- NPI
- 1265105258 Verify this NPI
- Provider Name
- PREMISE HEALTH OF SOUTH CAROLINA MEDICAL PC
- Other Name Type
- (6)
- Entity Type
- Organization
- Location Address
- 3127 MR JOE WHITE AVE MYRTLE BEACH, SC 29577
- Location Phone
- (843) 918-2040
- Mailing Address
- 5500 MARYLAND WAY BRENTWOOD, TN 37027
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 07-27-2021
- Last Update Date
- 02-04-2026
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Multi-Specialty
- Taxonomy Code
- 261QM1300X
- Type
- Ambulatory Health Care Facilities
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 this NPI number is:
- CLIA Number
- 42D2008406
- Facility Type
- Physician Office
- Certificate Effective Date
- June 10, 2026
- Certificate Expiration Date
- June 09, 2028
- Laboratory Director
- APRIL BLUE
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Premise Health Of South Carolina Medical Pc 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.
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Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1265105258, enumerated as an "organization" on July 27, 2021.
The provider is located at 3127 MR JOE WHITE AVE MYRTLE BEACH, SC 29577 and the phone number is (843) 918-2040.
Clinic/Center with taxonomy code 261QM1300X and a focus in Multi-Specialty.
