42D2012811 CLIA NUMBER - WALGREENS #07648

Laboratory Demographics

  • CLIA Code: 42D2012811
  • Facility Name: WALGREENS #07648
  • Facility Address: 2410 REIDVILLE RD
    SPARTANBURG, SC
    ZIP 29301
  • Facility Phone: 864 587-9486
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TIMOTHY DEROSE
  • NPI Number: 1194730283
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 42D2012811
LAB Type Pharmacy
Facility Name WALGREENS #07648
Street 2410 REIDVILLE RD
City SPARTANBURG
State SC
ZIP 29301
Phone 864 587-9486
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 TIMOTHY DEROSE

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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