42D2021185 CLIA NUMBER - WALGREENS #11563

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Laboratory Demographics

CLIA Number: 42D2021185

Facility Name: WALGREENS #11563

Facility Address:
4361 HIGHWAY 24
ANDERSON, SC
ZIP 29626
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Facility Phone Number: 864 224-8433

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1467617258

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	42D2021185
LAB Type	Pharmacy
Facility Name	WALGREENS #11563
Street	4361 HIGHWAY 24
City	ANDERSON
State	SC
ZIP	29626
Phone	864 224-8433
CertificateType	4
CertificateEffectiveDate	4/16/2023
CertificateExpirationDate	4/15/2025
FacilityType	Waiver

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