42D2288815 CLIA NUMBER - WALGREENS 06136

Laboratory Demographics

  • CLIA Code: 42D2288815
  • Facility Name: WALGREENS 06136
  • Facility Address: 4467 DEVINE STREET
    COLUMBIA, SC
    ZIP 29205
  • Facility Phone: 803 787-2527
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AJAY KALAN
  • NPI Number: 1003821190
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2288815
LAB Type Pharmacy
Facility Name WALGREENS 06136
Street 4467 DEVINE STREET
City COLUMBIA
State SC
ZIP 29205
Phone 803 787-2527
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/31/2025
Certificate Expiration Date 8/30/2027
Facility Type Pharmacy
Lab Director AJAY KALAN

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