CLIA lab
CLIA 42D0864419: Bon Secours Holly Tree Family Practice
Simpsonville, SC. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 42D0864419 belongs to Bon Secours Holly Tree Family Practice in Simpsonville, SC.
Certificate of Waiver, effective April 1, 2026, expires March 31, 2028.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Run it in Rivvi
Map your lab's test names to LOINC codes
Open in RivviFree to start. Opens Rivvi, the AI workspace for healthcare teams.
Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- April 1, 2026
- Certificate expiration
- March 31, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- September 1, 1992
- Facility type
- Physician office
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 42D0864419
- Lab name
- Bon Secours Holly Tree Family Practice
- Address
- 1338 Highway 14, Simpsonville, SC 29681
- Phone
- (864) 297-7091
- Fax
- (877) 379-3079
Annual test volume the lab reported
- Waived tests
- 2,000
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Simpsonville, SC
- Ascent Recovery Solutions, LLCCertificate of Waiver, Other42D2212745
- Ask Mobile Phlebotomy Labs LLCCertificate of Waiver, Mobile lab42D2326787
- Blufords Healthcare and AssociatesCertificate of Waiver, Physician office42D2321407
- Bon Secours - ST Francis LaboratoryCertificate of Accreditation, Ancillary test site42D2256046
- Bon Secours Ambulatory Services - ST Francis, LLCCertificate of Waiver, Other42D2082828
- Bon Secours Five Forks Emergency CenterCertificate of Registration, Ancillary test site42D2332698
- Brookstone Terrace of SimpsonvilleCertificate of Waiver, Assisted living facility42D2347287
- Bsmh Occupational Health On-Site at FitesaCertificate of Waiver, Industrial42D2262771
- Carolinas Center for Oral & Facial SurgeryCertificate of Waiver, Other practitioner42D2269575
- Celestial Midwifery ServicesCertificate of Waiver, Other practitioner42D2175150
Related
Questions
What is the CLIA number for Bon Secours Holly Tree Family Practice in Simpsonville?
42D0864419, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Bon Secours Holly Tree Family Practice hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 42D0864419 expire?
The CMS file lists March 31, 2028 as the certificate expiration date; the certificate took effect April 1, 2026.