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42D2218293 CLIA NUMBER - SOUTH CAROLINA CVS PHARMACY DBA CVS/PHARMACY #07366

Laboratory Demographics

CLIA Number: 42D2218293

Facility Name: SOUTH CAROLINA CVS PHARMACY DBA CVS/PHARMACY #07366

Facility Address:
4401 HWY 17 SOUTH
NORTH MYRTLE BEACH, SC
ZIP 29582
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Facility Phone Number: 401 770-6431

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1891898573

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 42D2218293
LAB Type Pharmacy
Facility Name SOUTH CAROLINA CVS PHARMACY DBA CVS/PHARMACY #07366
Street 4401 HWY 17 SOUTH
City NORTH MYRTLE BEACH
State SC
ZIP 29582
Phone 401 770-6431
CertificateType 4
CertificateEffectiveDate 3/26/2023
CertificateExpirationDate 3/25/2025
FacilityType Waiver

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