21D2061165 CLIA NUMBER - WALGREENS 09490

Laboratory Demographics

  • CLIA Code: 21D2061165
  • Facility Name: WALGREENS 09490
  • Facility Address: 3106 SOLOMONS ISLAND ROAD
    EDGEWATER, MD
    ZIP 21037
  • Facility Phone: 410 956-8319
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: THOMAS H. ROOT
  • NPI Number: 1487608626
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2061165
LAB Type Pharmacy
Facility Name WALGREENS 09490
Street 3106 SOLOMONS ISLAND ROAD
City EDGEWATER
State MD
ZIP 21037
Phone 410 956-8319
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/26/2024
Certificate Expiration Date 11/25/2026
Facility Type Pharmacy
Lab Director THOMAS H. ROOT

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