42D2043199 CLIA NUMBER - WALGREENS #10162

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Laboratory Demographics

CLIA Number: 42D2043199

Facility Name: WALGREENS #10162

Facility Address:
1716 PLEASANT RD
FORT MILL, SC
ZIP 29708
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Facility Phone Number: 803 802-7644

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1376060897

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	42D2043199
LAB Type	Pharmacy
Facility Name	WALGREENS #10162
Street	1716 PLEASANT RD
City	FORT MILL
State	SC
ZIP	29708
Phone	803 802-7644
CertificateType	4
CertificateEffectiveDate	4/16/2023
CertificateExpirationDate	4/15/2025
FacilityType	Waiver

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