42D1009405 CLIA NUMBER - CORAM HEALTHCARE/CAROLINA HOME THERAPEUTICS, LLC

Laboratory Demographics

CLIA Number: 42D1009405

Facility Name: CORAM HEALTHCARE/CAROLINA HOME THERAPEUTICS, LLC

Facility Address:
720 GRACERN ROAD, SUITE 123
COLUMBIA, SC
ZIP 29210
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Facility Phone Number: 803 731-5076

Facility Type: Other

Certificate Type: Waiver

NPI Number: 1134131352

Taxonomy: 3336H0001X - Pharmacy
Pharmacy-based, decentralized patient care organization with expertise in USP 797-compliant sterile drug compounding that provides care to patients with acute or chronic conditions generally pertaining to parenteral administration of drugs, biologics and nutritional formulae administered through catheters and/or needles in home and alternate sites. Extensive professional pharmacy services, care coordination, infusion nursing services, supplies and equipment are provided to optimize efficacy and compliance.

CLIA Record

Field Name	Field Value
CLIA Number	42D1009405
LAB Type	Other
Facility Name	CORAM HEALTHCARE/CAROLINA HOME THERAPEUTICS, LLC
Street	720 GRACERN ROAD, SUITE 123
City	COLUMBIA
State	SC
ZIP	29210
Phone	803 731-5076
CertificateType	4
CertificateEffectiveDate	2/13/2023
CertificateExpirationDate	2/12/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024