42D2217232 CLIA NUMBER - SOUTH CAROLINA CVS PHARMACY LLC DBA CVS/PHARMACY #02331

Laboratory Demographics

CLIA Number: 42D2217232

Facility Name: SOUTH CAROLINA CVS PHARMACY LLC DBA CVS/PHARMACY #02331

Facility Address:
718 MILLS AVENUE
GREENVILLE, SC
ZIP 29605
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Facility Phone Number: 401 770-6431

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1083717763

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	42D2217232
LAB Type	Pharmacy
Facility Name	SOUTH CAROLINA CVS PHARMACY LLC DBA CVS/PHARMACY #02331
Street	718 MILLS AVENUE
City	GREENVILLE
State	SC
ZIP	29605
Phone	401 770-6431
CertificateType	4
CertificateEffectiveDate	3/18/2023
CertificateExpirationDate	3/17/2025
FacilityType	Waiver

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