42D2021181 CLIA NUMBER - WALGREENS #10228

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Laboratory Demographics

CLIA Number: 42D2021181

Facility Name: WALGREENS #10228

Facility Address:
2725 CLEMSON RD
COLUMBIA, SC
ZIP 29229
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Facility Phone Number: 310 710-1688

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1881837664

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	42D2021181
LAB Type	Pharmacy
Facility Name	WALGREENS #10228
Street	2725 CLEMSON RD
City	COLUMBIA
State	SC
ZIP	29229
Phone	310 710-1688
CertificateType	4
CertificateEffectiveDate	12/17/2022
CertificateExpirationDate	12/16/2024
FacilityType	Waiver

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