21D2061161 CLIA NUMBER - WALGREENS #09032

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Laboratory Demographics

CLIA Number: 21D2061161

Facility Name: WALGREENS #09032

Facility Address:
25 HIGH ST
WALDORF, MD
ZIP 20602
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Facility Phone Number: 301 932-9826

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1255346441

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	21D2061161
LAB Type	Pharmacy
Facility Name	WALGREENS #09032
Street	25 HIGH ST
City	WALDORF
State	MD
ZIP	20602
Phone	301 932-9826
CertificateType	4
CertificateEffectiveDate	9/27/2023
CertificateExpirationDate	9/26/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024