42D2023099 CLIA NUMBER - WALGREENS #10100

Laboratory Demographics

  • CLIA Code: 42D2023099
  • Facility Name: WALGREENS #10100
  • Facility Address: 2198 SOUTHPORT RD
    SPARTANBURG, SC
    ZIP 29306
  • Facility Phone: 864 582-5822
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRADLEY J. ORR
  • NPI Number: 1508389545
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2023099
LAB Type Pharmacy
Facility Name WALGREENS #10100
Street 2198 SOUTHPORT RD
City SPARTANBURG
State SC
ZIP 29306
Phone 864 582-5822
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 BRADLEY J. ORR

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