42D2282327 CLIA NUMBER - SOUTH CAROLINA CVS PHARMACY, LLC DBA CVS/PHARMACY #05596

Laboratory Demographics

CLIA Number: 42D2282327

Facility Name: SOUTH CAROLINA CVS PHARMACY, LLC DBA CVS/PHARMACY #05596

Facility Address:
4627 NORTH MAIN STREET
COLUMBIA, SC
ZIP 29203
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Facility Phone Number: 803 786-1106

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1356444038

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	42D2282327
LAB Type	Pharmacy
Facility Name	SOUTH CAROLINA CVS PHARMACY, LLC DBA CVS/PHARMACY #05596
Street	4627 NORTH MAIN STREET
City	COLUMBIA
State	SC
ZIP	29203
Phone	803 786-1106
CertificateType	4
CertificateEffectiveDate	5/19/2023
CertificateExpirationDate	5/18/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024