42D2019700 CLIA NUMBER - WALGREENS #04980

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Laboratory Demographics

CLIA Number: 42D2019700

Facility Name: WALGREENS #04980

Facility Address:
20 HATTON PL, #100
HILTON HEAD ISLAND, SC
ZIP 29926
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Facility Phone Number: 843 342-7451

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1376558445

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	42D2019700
LAB Type	Pharmacy
Facility Name	WALGREENS #04980
Street	20 HATTON PL, #100
City	HILTON HEAD ISLAND
State	SC
ZIP	29926
Phone	843 342-7451
CertificateType	4
CertificateEffectiveDate	3/26/2023
CertificateExpirationDate	3/25/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024