42D2251913 CLIA NUMBER - WALGREENS #17294

Laboratory Demographics

  • CLIA Code: 42D2251913
  • Facility Name: WALGREENS #17294
  • Facility Address: 1000 N PINE STREET
    SPARTANBURG, SC
    ZIP 29303
  • Facility Phone: 864 585-9136
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NIKKO WARE
  • NPI Number: 1881118511
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2251913
LAB Type Pharmacy
Facility Name WALGREENS #17294
Street 1000 N PINE STREET
City SPARTANBURG
State SC
ZIP 29303
Phone 864 585-9136
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/7/2024
Certificate Expiration Date 2/6/2026
Facility Type Pharmacy
Lab Director NIKKO WARE

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