42D2043185 CLIA NUMBER - WALGREENS#10838

Laboratory Demographics

  • CLIA Code: 42D2043185
  • Facility Name: WALGREENS#10838
  • Facility Address: 5220 HIGHWAY 557
    LAKE WYLIE, SC
    ZIP 29710
  • Facility Phone: 803 631-4144
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: QUYNH NHU T HUYNH
  • NPI Number: 1477787562
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2043185
LAB Type Pharmacy
Facility Name WALGREENS#10838
Street 5220 HIGHWAY 557
City LAKE WYLIE
State SC
ZIP 29710
Phone 803 631-4144
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/22/2025
Certificate Expiration Date 4/21/2027
Facility Type Pharmacy
Lab Director QUYNH NHU T HUYNH

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