21D2061443 CLIA NUMBER - WALGREENS#11037

Laboratory Demographics

  • CLIA Code: 21D2061443
  • Facility Name: WALGREENS#11037
  • Facility Address: 2556 PULASKI HWY
    NORTHEAST, MD
    ZIP 21901
  • Facility Phone: 410 287-8887
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AMOLKUMAR A. SHINGAVI
  • NPI Number: 1306867759
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2061443
LAB Type Pharmacy
Facility Name WALGREENS#11037
Street 2556 PULASKI HWY
City NORTHEAST
State MD
ZIP 21901
Phone 410 287-8887
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 AMOLKUMAR A. SHINGAVI

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