21D2061212 CLIA NUMBER - WALGREENS #13893

Laboratory Demographics

  • CLIA Code: 21D2061212
  • Facility Name: WALGREENS #13893
  • Facility Address: 1631 DUAL HWY
    HAGERSTOWN, MD
    ZIP 21740
  • Facility Phone: 240 313-9165
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SANDY Y. AZER
  • NPI Number: 1831436187
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2061212
LAB Type Pharmacy
Facility Name WALGREENS #13893
Street 1631 DUAL HWY
City HAGERSTOWN
State MD
ZIP 21740
Phone 240 313-9165
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/4/2025
Certificate Expiration Date 10/3/2027
Facility Type Pharmacy
Lab Director SANDY Y. AZER

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