21D2061211 CLIA NUMBER - WALGREENS, #7678

Laboratory Demographics

  • CLIA Code: 21D2061211
  • Facility Name: WALGREENS, #7678
  • Facility Address: 1260 LIBERTY ROAD
    ELDERSBURG, MD
    ZIP 21784
  • Facility Phone: 410 795-2968
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: GWENDOLINE EGBE
  • NPI Number: 1659568525
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2061211
LAB Type Pharmacy
Facility Name WALGREENS, #7678
Street 1260 LIBERTY ROAD
City ELDERSBURG
State MD
ZIP 21784
Phone 410 795-2968
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/31/2023
Certificate Expiration Date 10/30/2025
Facility Type Pharmacy
Lab Director GWENDOLINE EGBE

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