21D2061102 CLIA NUMBER - WALGREENS #13816

Laboratory Demographics

  • CLIA Code: 21D2061102
  • Facility Name: WALGREENS #13816
  • Facility Address: 8374 PINEY ORCHARD PKWY
    ODENTON, MD
    ZIP 21113
  • Facility Phone: 410 305-1239
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KANAYO C. EKEADA
  • NPI Number: 1215287552
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2061102
LAB Type Pharmacy
Facility Name WALGREENS #13816
Street 8374 PINEY ORCHARD PKWY
City ODENTON
State MD
ZIP 21113
Phone 410 305-1239
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/8/2023
Certificate Expiration Date 11/7/2025
Facility Type Pharmacy
Lab Director KANAYO C. EKEADA

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