42D2012795 CLIA NUMBER - WALGREENS #09284

Laboratory Demographics

  • CLIA Code: 42D2012795
  • Facility Name: WALGREENS #09284
  • Facility Address: 1326 N JEFFERIES BLVD
    WALTERBORO, SC
    ZIP 29488
  • Facility Phone: 843 549-6781
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KAMEAKA MACK GARVIN
  • NPI Number: 1457366544
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2012795
LAB Type Pharmacy
Facility Name WALGREENS #09284
Street 1326 N JEFFERIES BLVD
City WALTERBORO
State SC
ZIP 29488
Phone 843 549-6781
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/26/2025
Certificate Expiration Date 3/25/2027
Facility Type Pharmacy
Lab Director KAMEAKA MACK GARVIN

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