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42D2218089 CLIA NUMBER - WALGREENS #17330

Laboratory Demographics

CLIA Number: 42D2218089

Facility Name: WALGREENS #17330

Facility Address:
201 EAST MAIN STREET
WILLIAMSTON, SC
ZIP 29697
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Facility Phone Number: 864 847-9071

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1225552995

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 42D2218089
LAB Type Pharmacy
Facility Name WALGREENS #17330
Street 201 EAST MAIN STREET
City WILLIAMSTON
State SC
ZIP 29697
Phone 864 847-9071
CertificateType 4
CertificateEffectiveDate 3/25/2023
CertificateExpirationDate 3/24/2025
FacilityType Waiver

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