42D2226662 CLIA NUMBER - WALGREENS #15630

Laboratory Demographics

  • CLIA Code: 42D2226662
  • Facility Name: WALGREENS #15630
  • Facility Address: 907 FOLLY ROAD
    CHARLESTON, SC
    ZIP 29412
  • Facility Phone: 843 795-5452
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DANIEL PEPE
  • NPI Number: 1134503261
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2226662
LAB Type Pharmacy
Facility Name WALGREENS #15630
Street 907 FOLLY ROAD
City CHARLESTON
State SC
ZIP 29412
Phone 843 795-5452
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/2/2025
Certificate Expiration Date 6/1/2027
Facility Type Pharmacy
Lab Director DANIEL PEPE

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This page was last updated on: 6/4/2025