42D2250668 CLIA NUMBER - SUMMERTON DRUGS COMPOUNDING & DISPENSARY, LLC

Laboratory Demographics

  • CLIA Code: 42D2250668
  • Facility Name: SUMMERTON DRUGS COMPOUNDING & DISPENSARY, LLC
  • Facility Address: 115B MAIN STREET
    SUMMERTON, SC
    ZIP 29148
  • Facility Phone: 803 485-8586
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ERNEST E. PHILLIPS
  • NPI Number: 1740725100
  • Taxonomy: 363LA2200X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 42D2250668
LAB Type Pharmacy
Facility Name SUMMERTON DRUGS COMPOUNDING & DISPENSARY, LLC
Street 115B MAIN STREET
City SUMMERTON
State SC
ZIP 29148
Phone 803 485-8586
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/28/2024
Certificate Expiration Date 1/27/2026
Facility Type Pharmacy
Lab Director ERNEST E. PHILLIPS

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