42D2012814 CLIA NUMBER - WALGREENS #10163

Laboratory Demographics

  • CLIA Code: 42D2012814
  • Facility Name: WALGREENS #10163
  • Facility Address: 1601 SANDIFER BLVD
    SENECA, SC
    ZIP 29678
  • Facility Phone: 864 885-0889
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: STANZIONE B. LEE
  • NPI Number: 1801313325
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2012814
LAB Type Pharmacy
Facility Name WALGREENS #10163
Street 1601 SANDIFER BLVD
City SENECA
State SC
ZIP 29678
Phone 864 885-0889
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/3/2023
Certificate Expiration Date 6/2/2025
Facility Type Pharmacy
Lab Director STANZIONE B. LEE

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This page was last updated on: 3/20/2025