21D2061239 CLIA NUMBER - WALGREENS #9632

Laboratory Demographics

  • CLIA Code: 21D2061239
  • Facility Name: WALGREENS #9632
  • Facility Address: 2970 SHASHO PL
    WALDORF, MD
    ZIP 20603
  • Facility Phone: 301 645-3095
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: EYITAYO AKODA
  • NPI Number: 1255537247
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 21D2061239
LAB Type Pharmacy
Facility Name WALGREENS #9632
Street 2970 SHASHO PL
City WALDORF
State MD
ZIP 20603
Phone 301 645-3095
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 EYITAYO AKODA

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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