42D2231376 CLIA NUMBER - WALGREENS #17258

Laboratory Demographics

  • CLIA Code: 42D2231376
  • Facility Name: WALGREENS #17258
  • Facility Address: 5001 SOCASTEE BOULEVARD
    MYRTLE BEACH, SC
    ZIP 29588
  • Facility Phone: 843 293-6066
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALEC MARINARO
  • NPI Number: 1831615715
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2231376
LAB Type Pharmacy
Facility Name WALGREENS #17258
Street 5001 SOCASTEE BOULEVARD
City MYRTLE BEACH
State SC
ZIP 29588
Phone 843 293-6066
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/3/2025
Certificate Expiration Date 8/2/2027
Facility Type Pharmacy
Lab Director ALEC MARINARO

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