42D2267915 CLIA NUMBER - PROSPERITY DRUG COMPANY

Laboratory Demographics

  • CLIA Code: 42D2267915
  • Facility Name: PROSPERITY DRUG COMPANY
  • Facility Address: 110 N MAIN STREET
    PROSPERITY, SC
    ZIP 29127
  • Facility Phone: 803 364-2310
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MR. JOHN W. PUGH
  • NPI Number: 1215973334
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2267915
LAB Type Pharmacy
Facility Name PROSPERITY DRUG COMPANY
Street 110 N MAIN STREET
City PROSPERITY
State SC
ZIP 29127
Phone 803 364-2310
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/2/2024
Certificate Expiration Date 9/1/2026
Facility Type Pharmacy
Lab Director MR. JOHN W. PUGH

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