42D2025229 CLIA NUMBER - WALGREENS # 10226

Laboratory Demographics

  • CLIA Code: 42D2025229
  • Facility Name: WALGREENS # 10226
  • Facility Address: 1251 DUTCH FORK RD
    IRMO, SC
    ZIP 29063
  • Facility Phone: 803 749-7099
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JASON P. DOUGLAS
  • NPI Number: 1932626462
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2025229
LAB Type Pharmacy
Facility Name WALGREENS # 10226
Street 1251 DUTCH FORK RD
City IRMO
State SC
ZIP 29063
Phone 803 749-7099
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/29/2025
Certificate Expiration Date 3/28/2027
Facility Type Pharmacy
Lab Director JASON P. DOUGLAS

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This page was last updated on: 6/4/2025