CLIA lab
CLIA 42D1075596: Lake Wylie Assisted Living Community
Lake Wylie, SC. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 42D1075596 belongs to Lake Wylie Assisted Living Community in Lake Wylie, SC.
Certificate of Waiver, effective October 24, 2025, expires October 23, 2027.
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
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- October 24, 2025
- Certificate expiration
- October 23, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- October 24, 2007
- Facility type
- Other
- 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
- 42D1075596
- Lab name
- Lake Wylie Assisted Living Community
- Additional name
- Lake Wylie Assisted Living LLC DBA
- Address
- 4877 Charlotte Hwy, Lake Wylie, SC 29710
- Phone
- (803) 831-9900
- Fax
- (803) 831-9194
Annual test volume the lab reported
- Waived tests
- 100
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Lake Wylie, SC
- Caromont Urgent Care-Lake WylieCertificate of Waiver, Physician office42D2213658
- Endocrinology Associates - Lake WylieCertificate of Waiver, Physician office42D2125946
- Gentle Sticks Mobile Phlebotomy, LLCCertificate of Waiver, Mobile lab42D2225069
- Lake Wylie PharmacyCertificate of Waiver, Pharmacy42D2182790
- Sunflower Springs of Lake WylieCertificate of Waiver, Assisted living facility42D2325349
- TLC Your Way Home Care Services, IncCertificate of Waiver, Home health agency42D2237165
- Walgreens#10838Certificate of Waiver, Pharmacy42D2043185
- Walmart Pharmacy 10-5745Certificate of Waiver, Pharmacy42D2181949
Related
Questions
What is the CLIA number for Lake Wylie Assisted Living Community in Lake Wylie?
42D1075596, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Lake Wylie Assisted Living Community hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 42D1075596 expire?
The CMS file lists October 23, 2027 as the certificate expiration date; the certificate took effect October 24, 2025.