42D2183322 CLIA NUMBER - HAWTHORNE PHARMACY, INC

Laboratory Demographics

CLIA Number: 42D2183322

Facility Name: HAWTHORNE PHARMACY, INC

Facility Address:
1520A TAYLOR STREET
COLUMBIA, SC
ZIP 29201
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Facility Phone Number: 803 256-3440

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1891704672

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	42D2183322
LAB Type	Pharmacy
Facility Name	HAWTHORNE PHARMACY, INC
Street	1520A TAYLOR STREET
City	COLUMBIA
State	SC
ZIP	29201
Phone	803 256-3440
CertificateType	4
CertificateEffectiveDate	5/4/2024
CertificateExpirationDate	5/3/2026
FacilityType	Waiver

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