42D2228870 CLIA NUMBER - WALGREENS #17741

Laboratory Demographics

CLIA Number: 42D2228870

Facility Name: WALGREENS #17741

Facility Address:
137 SOUTH MAIN STREET
ALLENDALE, SC
ZIP 29810
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Facility Phone Number: 803 584-7735

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1699298604

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	42D2228870
LAB Type	Pharmacy
Facility Name	WALGREENS #17741
Street	137 SOUTH MAIN STREET
City	ALLENDALE
State	SC
ZIP	29810
Phone	803 584-7735
CertificateType	4
CertificateEffectiveDate	7/1/2023
CertificateExpirationDate	6/30/2025
FacilityType	Waiver

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