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21D2061439 CLIA NUMBER - WALGREENS #11500

Laboratory Demographics

CLIA Number: 21D2061439

Facility Name: WALGREENS #11500

Facility Address:
15990 ANNAPOLIS ROAD
BOWIE, MD
ZIP 20715
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Facility Phone Number: 301 352-2340

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1265897524

Taxonomy: 183500000X - Pharmacist
An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.

CLIA Record

Field Name Field Value
CLIA Number 21D2061439
LAB Type Pharmacy
Facility Name WALGREENS #11500
Street 15990 ANNAPOLIS ROAD
City BOWIE
State MD
ZIP 20715
Phone 301 352-2340
CertificateType 4
CertificateEffectiveDate 9/27/2023
CertificateExpirationDate 9/26/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024