21D2067899 CLIA NUMBER - WALGREENS #10905

Laboratory Demographics

  • CLIA Code: 21D2067899
  • Facility Name: WALGREENS #10905
  • Facility Address: 640 SUNBURST HWY
    CAMBRIDGE, MD
    ZIP 21613
  • Facility Phone: 410 901-6290
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANAB EIBBA
  • NPI Number: 1700041514
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2067899
LAB Type Pharmacy
Facility Name WALGREENS #10905
Street 640 SUNBURST HWY
City CAMBRIDGE
State MD
ZIP 21613
Phone 410 901-6290
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 ANAB EIBBA

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