21D2061439 CLIA NUMBER - WALGREENS #11500

Laboratory Demographics

  • CLIA Code: 21D2061439
  • Facility Name: WALGREENS #11500
  • Facility Address: 15990 ANNAPOLIS ROAD
    BOWIE, MD
    ZIP 20715
  • Facility Phone: 301 352-2340
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: HONG YANG
  • NPI Number: 1265897524
  • Taxonomy: 183500000X - Pharmacist

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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
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 HONG YANG

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