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42D2231333 CLIA NUMBER - WALGREENS #17370

Laboratory Demographics

CLIA Number: 42D2231333

Facility Name: WALGREENS #17370

Facility Address:
4730 FOREST DRIVE
COLUMBIA, SC
ZIP 29206
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Facility Phone Number: 803 787-7362

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1073038691

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 42D2231333
LAB Type Pharmacy
Facility Name WALGREENS #17370
Street 4730 FOREST DRIVE
City COLUMBIA
State SC
ZIP 29206
Phone 803 787-7362
CertificateType 4
CertificateEffectiveDate 8/2/2023
CertificateExpirationDate 8/1/2025
FacilityType Waiver

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