21D2061442 CLIA NUMBER - WALGREENS #12324

Laboratory Demographics

  • CLIA Code: 21D2061442
  • Facility Name: WALGREENS #12324
  • Facility Address: 1595 OPPOSUMTOWN PIKE
    FREDERICK, MD
    ZIP 21702
  • Facility Phone: 301 631-2013
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RICHARD G. NUBILA
  • NPI Number: 1912273137
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2061442
LAB Type Pharmacy
Facility Name WALGREENS #12324
Street 1595 OPPOSUMTOWN PIKE
City FREDERICK
State MD
ZIP 21702
Phone 301 631-2013
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 RICHARD G. NUBILA

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