42D1092255 CLIA NUMBER - WALGREENS #10391

Laboratory Demographics

  • CLIA Code: 42D1092255
  • Facility Name: WALGREENS #10391
  • Facility Address: 2586 WOODRUFF RD
    SIMPSONVILLE, SC
    ZIP 29681
  • Facility Phone: 864 288-8836
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JESSICA M. LABODA
  • NPI Number: 1699292102
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D1092255
LAB Type Pharmacy
Facility Name WALGREENS #10391
Street 2586 WOODRUFF RD
City SIMPSONVILLE
State SC
ZIP 29681
Phone 864 288-8836
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/20/2025
Certificate Expiration Date 10/19/2027
Facility Type Pharmacy
Lab Director JESSICA M. LABODA

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This page was last updated on: 9/29/2025