42D2183895 CLIA NUMBER - HAWTHORNE LUGOFF PHARMACY, LLC

Laboratory Demographics

  • CLIA Code: 42D2183895
  • Facility Name: HAWTHORNE LUGOFF PHARMACY, LLC
  • Facility Address: 710 HIGHWAY 1 SOUTH
    LUGOFF, SC
    ZIP 29078
  • Facility Phone: 803 408-9589
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KRISTIE S. CASSIDY
  • NPI Number: 1114251337
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2183895
LAB Type Pharmacy
Facility Name HAWTHORNE LUGOFF PHARMACY, LLC
Street 710 HIGHWAY 1 SOUTH
City LUGOFF
State SC
ZIP 29078
Phone 803 408-9589
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/12/2024
Certificate Expiration Date 5/11/2026
Facility Type Pharmacy
Lab Director KRISTIE S. CASSIDY

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