42D2182785 CLIA NUMBER - PINE RIDGE PHARMACY

Laboratory Demographics

  • CLIA Code: 42D2182785
  • Facility Name: PINE RIDGE PHARMACY
  • Facility Address: 634A PINE RIDGE DRIVE
    WEST COLUMBIA, SC
    ZIP 29172
  • Facility Phone: 803 955-3404
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KYLE MCHUGH
  • NPI Number: 1750527834
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2182785
LAB Type Pharmacy
Facility Name PINE RIDGE PHARMACY
Street 634A PINE RIDGE DRIVE
City WEST COLUMBIA
State SC
ZIP 29172
Phone 803 955-3404
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 KYLE MCHUGH

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