42D2290636 CLIA NUMBER - MEDCARE PHARMACY

Laboratory Demographics

  • CLIA Code: 42D2290636
  • Facility Name: MEDCARE PHARMACY
  • Facility Address: 1114 COTTINGHAM BLVD, SUITE B
    BENNETTSVILLE, SC
    ZIP 29512
  • Facility Phone: 843 479-7107
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SYMEONIDIS SOLON
  • NPI Number: 1649518036
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2290636
LAB Type Pharmacy
Facility Name MEDCARE PHARMACY
Street 1114 COTTINGHAM BLVD, SUITE B
City BENNETTSVILLE
State SC
ZIP 29512
Phone 843 479-7107
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/28/2025
Certificate Expiration Date 9/27/2027
Facility Type Pharmacy
Lab Director SYMEONIDIS SOLON

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