42D2233393 CLIA NUMBER - WANNAMAKER DRUG

Laboratory Demographics

  • CLIA Code: 42D2233393
  • Facility Name: WANNAMAKER DRUG
  • Facility Address: 107 WEST BLVD
    CHESTERFIELD, SC
    ZIP 29709
  • Facility Phone: 843 623-2999
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LISA R. BRIDGES
  • NPI Number: 1730311432
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2233393
LAB Type Pharmacy
Facility Name WANNAMAKER DRUG
Street 107 WEST BLVD
City CHESTERFIELD
State SC
ZIP 29709
Phone 843 623-2999
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/23/2025
Certificate Expiration Date 8/22/2027
Facility Type Pharmacy
Lab Director LISA R. BRIDGES

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