42D2295925 CLIA NUMBER - WALGREENS 17121

Laboratory Demographics

  • CLIA Code: 42D2295925
  • Facility Name: WALGREENS 17121
  • Facility Address: 302 VILLAGE CREEK DRIVE
    BOILING SPRINGS, SC
    ZIP 29316
  • Facility Phone: 864 345-6066
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHONG H. LO
  • NPI Number: 1144743170
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 42D2295925
LAB Type Pharmacy
Facility Name WALGREENS 17121
Street 302 VILLAGE CREEK DRIVE
City BOILING SPRINGS
State SC
ZIP 29316
Phone 864 345-6066
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/19/2023
Certificate Expiration Date 12/18/2025
Facility Type Pharmacy
Lab Director CHONG H. LO

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