42D2012790 CLIA NUMBER - WALGREENS #07154

Laboratory Demographics

  • CLIA Code: 42D2012790
  • Facility Name: WALGREENS #07154
  • Facility Address: 1601 CHURCH ST
    CONWAY, SC
    ZIP 29526
  • Facility Phone: 843 488-2000
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ART KALTSOUNIS
  • NPI Number: 1184639254
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2012790
LAB Type Pharmacy
Facility Name WALGREENS #07154
Street 1601 CHURCH ST
City CONWAY
State SC
ZIP 29526
Phone 843 488-2000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/6/2025
Certificate Expiration Date 4/5/2027
Facility Type Pharmacy
Lab Director ART KALTSOUNIS

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