42D2182771 CLIA NUMBER - ELLOREE PHARMACY, LLC

Laboratory Demographics

  • CLIA Code: 42D2182771
  • Facility Name: ELLOREE PHARMACY, LLC
  • Facility Address: 2611 CLEVELAND STREET
    ELLOREE, SC
    ZIP 29047
  • Facility Phone: 803 897-2131
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: STAN LAWHON
  • NPI Number: 1912963745
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2182771
LAB Type Pharmacy
Facility Name ELLOREE PHARMACY, LLC
Street 2611 CLEVELAND STREET
City ELLOREE
State SC
ZIP 29047
Phone 803 897-2131
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/27/2024
Certificate Expiration Date 4/26/2026
Facility Type Pharmacy
Lab Director STAN LAWHON

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