42D2006477 CLIA NUMBER - WALGREENS #11379

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Laboratory Demographics

CLIA Number: 42D2006477

Facility Name: WALGREENS #11379

Facility Address:
7801 GARNERS FERRY RD
COLUMBIA, SC
ZIP 29209
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Facility Phone Number: 803 647-7638

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1841437266

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	42D2006477
LAB Type	Pharmacy
Facility Name	WALGREENS #11379
Street	7801 GARNERS FERRY RD
City	COLUMBIA
State	SC
ZIP	29209
Phone	803 647-7638
CertificateType	4
CertificateEffectiveDate	3/16/2023
CertificateExpirationDate	3/15/2025
FacilityType	Waiver

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