CLIA lab
CLIA 42D2165955: Mary's Residential Care Facility
Blythewood, SC. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 42D2165955 belongs to Mary's Residential Care Facility in Blythewood, SC.
Certificate of Waiver, effective May 8, 2025, expires May 7, 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
- May 8, 2025
- Certificate expiration
- May 7, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- May 8, 2019
- Facility type
- Assisted living facility
- 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
- 42D2165955
- Lab name
- Mary's Residential Care Facility
- Address
- 10425 Wilson Blvd, Blythewood, SC 29016
- Phone
- (803) 556-9813
- Fax
- (803) 708-0300
Annual test volume the lab reported
- Waived tests
- 600
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Blythewood, SC
- Ala Blythewood K-12Certificate of Waiver, School or student health service42D2346059
- Blythewood Family MedicineCertificate of Registration, Physician office42D1003749
- Ensight Laboratories, LLCCertificate of Waiver, Independent42D2252311
- LMC Occupational Health at Scout MotorsCertificate of Waiver, Physician office42D2312643
- Musc Health Primary Care BlythewoodCertificate for Provider-Performed Microscopy Procedures, Physician office42D2287255
- Palmetto PediatricsCertificate of Compliance, Physician office42D1081929
- Prince George TransportationCertificate of Waiver, Ambulance42D2269593
- Quality Dot Drug Screen & MoreCertificate of Waiver, Mobile lab42D2339989
- SHC Spirax-SarcoCertificate of Waiver, Other42D2124486
Related
Questions
What is the CLIA number for Mary's Residential Care Facility in Blythewood?
42D2165955, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Mary's Residential Care Facility hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 42D2165955 expire?
The CMS file lists May 7, 2027 as the certificate expiration date; the certificate took effect May 8, 2025.