42D2019741 CLIA NUMBER - WALGREENS #9834

Laboratory Demographics

  • CLIA Code: 42D2019741
  • Facility Name: WALGREENS #9834
  • Facility Address: 1098 N FRASER ST
    GEORGETOWN, SC
    ZIP 29440
  • Facility Phone: 843 545-1732
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TIARA S. THOMAS
  • NPI Number: 1265955264
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2019741
LAB Type Pharmacy
Facility Name WALGREENS #9834
Street 1098 N FRASER ST
City GEORGETOWN
State SC
ZIP 29440
Phone 843 545-1732
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/25/2025
Certificate Expiration Date 3/24/2027
Facility Type Pharmacy
Lab Director TIARA S. THOMAS

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