21D2063335 CLIA NUMBER - WALGREENS #10063

Laboratory Demographics

  • CLIA Code: 21D2063335
  • Facility Name: WALGREENS #10063
  • Facility Address: 6300 CRAIN HWY
    LA PLATA, MD
    ZIP 20646
  • Facility Phone: 301 392-6116
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: UZOAMAKA A. UKEDMAH
  • NPI Number: 1013187384
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2063335
LAB Type Pharmacy
Facility Name WALGREENS #10063
Street 6300 CRAIN HWY
City LA PLATA
State MD
ZIP 20646
Phone 301 392-6116
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/31/2023
Certificate Expiration Date 10/30/2025
Facility Type Pharmacy
Lab Director UZOAMAKA A. UKEDMAH

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