42D2042582 CLIA NUMBER - WALGREENS #11851

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Laboratory Demographics

CLIA Number: 42D2042582

Facility Name: WALGREENS #11851

Facility Address:
1532 LAKE MURRAY BLVD
COLUMBIA, SC
ZIP 29212
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Facility Phone Number: 803 732-1975

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1306004478

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	42D2042582
LAB Type	Pharmacy
Facility Name	WALGREENS #11851
Street	1532 LAKE MURRAY BLVD
City	COLUMBIA
State	SC
ZIP	29212
Phone	803 732-1975
CertificateType	4
CertificateEffectiveDate	4/22/2023
CertificateExpirationDate	4/21/2025
FacilityType	Waiver

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