42D2190908 CLIA NUMBER - SOUTH CAROLINA CVS PHARMACY, LLC DBA CVS PHARMACY 3560

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Laboratory Demographics

CLIA Number: 42D2190908

Facility Name: SOUTH CAROLINA CVS PHARMACY, LLC DBA CVS PHARMACY 3560

Facility Address:
1020 ORANGE GROVE RD
CHARLESTON, SC
ZIP 29407
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Facility Phone Number: 401 770-6431

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1649238916

Taxonomy: 2085R0202X - Radiology
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

CLIA Record

Field Name	Field Value
CLIA Number	42D2190908
LAB Type	Pharmacy
Facility Name	SOUTH CAROLINA CVS PHARMACY, LLC DBA CVS PHARMACY 3560
Street	1020 ORANGE GROVE RD
City	CHARLESTON
State	SC
ZIP	29407
Phone	401 770-6431
CertificateType	4
CertificateEffectiveDate	8/20/2022
CertificateExpirationDate	8/19/2024
FacilityType	Waiver

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