42D2105780 CLIA NUMBER - HARRIS TEETER #363

Laboratory Demographics

  • CLIA Code: 42D2105780
  • Facility Name: HARRIS TEETER #363
  • Facility Address: 9500 DORCHESTER RD
    SUMMERVILLE, SC
    ZIP 29485
  • Facility Phone: 843 875-2528
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LINDSAY CAPOZZIELLO
  • NPI Number: 1043641020
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2105780
LAB Type Pharmacy
Facility Name HARRIS TEETER #363
Street 9500 DORCHESTER RD
City SUMMERVILLE
State SC
ZIP 29485
Phone 843 875-2528
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/3/2023
Certificate Expiration Date 12/2/2025
Facility Type Pharmacy
Lab Director LINDSAY CAPOZZIELLO

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