42D2012808 CLIA NUMBER - WALGREENS #09230

Laboratory Demographics

  • CLIA Code: 42D2012808
  • Facility Name: WALGREENS #09230
  • Facility Address: 618 FAIRVIEW RD
    SIMPSONVILLE, SC
    ZIP 29680
  • Facility Phone: 864 962-1839
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KRISTINE LOSEE
  • NPI Number: 1548275639
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2012808
LAB Type Pharmacy
Facility Name WALGREENS #09230
Street 618 FAIRVIEW RD
City SIMPSONVILLE
State SC
ZIP 29680
Phone 864 962-1839
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/22/2025
Certificate Expiration Date 4/21/2027
Facility Type Pharmacy
Lab Director KRISTINE LOSEE

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