42D2043199 CLIA NUMBER - WALGREENS #10162

Laboratory Demographics

  • CLIA Code: 42D2043199
  • Facility Name: WALGREENS #10162
  • Facility Address: 1716 PLEASANT RD
    FORT MILL, SC
    ZIP 29708
  • Facility Phone: 803 802-7644
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHAEL P. MANNO
  • NPI Number: 1376060897
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2043199
LAB Type Pharmacy
Facility Name WALGREENS #10162
Street 1716 PLEASANT RD
City FORT MILL
State SC
ZIP 29708
Phone 803 802-7644
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/16/2025
Certificate Expiration Date 4/15/2027
Facility Type Pharmacy
Lab Director MICHAEL P. MANNO

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