42D2282340 CLIA NUMBER - SOUTH CAROLINA CVS PHARMACY, LLC DBA CVS/PHARMACY #04388

Laboratory Demographics

CLIA Number: 42D2282340

Facility Name: SOUTH CAROLINA CVS PHARMACY, LLC DBA CVS/PHARMACY #04388

Facility Address:
4295 JEFFERSON DAVIS HIGHWAY
BEECH ISLAND, SC
ZIP 29842
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Facility Phone Number: 803 593-5196

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1790888469

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	42D2282340
LAB Type	Pharmacy
Facility Name	SOUTH CAROLINA CVS PHARMACY, LLC DBA CVS/PHARMACY #04388
Street	4295 JEFFERSON DAVIS HIGHWAY
City	BEECH ISLAND
State	SC
ZIP	29842
Phone	803 593-5196
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