42D2225768 CLIA NUMBER - SOUTH CAROLINA CVS PHARMACY, LLC DBA CVSPHARMACY #02190

Laboratory Demographics

  • CLIA Code: 42D2225768
  • Facility Name: SOUTH CAROLINA CVS PHARMACY, LLC DBA CVSPHARMACY #02190
  • Facility Address: 1141 STATE PARK RD
    GREENVILLE, SC
    ZIP 29609
  • Facility Phone: 866 389-2727
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KEVIN ASH
  • NPI Number: 1093812596
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2225768
LAB Type Pharmacy
Facility Name SOUTH CAROLINA CVS PHARMACY, LLC DBA CVSPHARMACY #02190
Street 1141 STATE PARK RD
City GREENVILLE
State SC
ZIP 29609
Phone 866 389-2727
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/24/2025
Certificate Expiration Date 5/23/2027
Facility Type Pharmacy
Lab Director KEVIN ASH

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