42D2006474 CLIA NUMBER - WALGREENS #11724

Laboratory Demographics

  • CLIA Code: 42D2006474
  • Facility Name: WALGREENS #11724
  • Facility Address: 201 N LAFAYETTE DR
    SUMTER, SC
    ZIP 29150
  • Facility Phone: 803 773-4959
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: STACY L. WALIGURA
  • NPI Number: 1093720161
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2006474
LAB Type Pharmacy
Facility Name WALGREENS #11724
Street 201 N LAFAYETTE DR
City SUMTER
State SC
ZIP 29150
Phone 803 773-4959
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/22/2024
Certificate Expiration Date 12/21/2026
Facility Type Pharmacy
Lab Director STACY L. WALIGURA

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