42D2021191 CLIA NUMBER - WALGREENS # 07822

Laboratory Demographics

  • CLIA Code: 42D2021191
  • Facility Name: WALGREENS # 07822
  • Facility Address: 1790 E MAIN ST
    SPARTANBURG, SC
    ZIP 29307
  • Facility Phone: 864 583-2196
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: REBECCA WISE
  • NPI Number: 1720093818
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2021191
LAB Type Pharmacy
Facility Name WALGREENS # 07822
Street 1790 E MAIN ST
City SPARTANBURG
State SC
ZIP 29307
Phone 864 583-2196
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/26/2025
Certificate Expiration Date 4/25/2027
Facility Type Pharmacy
Lab Director REBECCA WISE

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