21D2061408 CLIA NUMBER - WALGREENS #10976

Laboratory Demographics

  • CLIA Code: 21D2061408
  • Facility Name: WALGREENS #10976
  • Facility Address: 9001 WOODY TER
    CLINTON, MD
    ZIP 20735
  • Facility Phone: 301 856-6501
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JONATHAN LEE
  • NPI Number: 1184883019
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2061408
LAB Type Pharmacy
Facility Name WALGREENS #10976
Street 9001 WOODY TER
City CLINTON
State MD
ZIP 20735
Phone 301 856-6501
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/27/2025
Certificate Expiration Date 9/26/2027
Facility Type Pharmacy
Lab Director JONATHAN LEE

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