42D2021728 CLIA NUMBER - WALGREENS #06687

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Laboratory Demographics

CLIA Number: 42D2021728

Facility Name: WALGREENS #06687

Facility Address:
4300 HIGHWAY 17 S
N MYRTLE BEACH, SC
ZIP 29582
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Facility Phone Number: 843 272-8399

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1548275613

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	42D2021728
LAB Type	Pharmacy
Facility Name	WALGREENS #06687
Street	4300 HIGHWAY 17 S
City	N MYRTLE BEACH
State	SC
ZIP	29582
Phone	843 272-8399
CertificateType	4
CertificateEffectiveDate	8/3/2023
CertificateExpirationDate	8/2/2025
FacilityType	Waiver

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