21D2067903 CLIA NUMBER - WALGREENS #11763

Laboratory Demographics

  • CLIA Code: 21D2067903
  • Facility Name: WALGREENS #11763
  • Facility Address: 701 WASHINGTON AVE
    CHESTERTOWN, MD
    ZIP 21620
  • Facility Phone: 410 778-5698
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MATTHEW T. SMITHMYER
  • NPI Number: 1811918139
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2067903
LAB Type Pharmacy
Facility Name WALGREENS #11763
Street 701 WASHINGTON AVE
City CHESTERTOWN
State MD
ZIP 21620
Phone 410 778-5698
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 MATTHEW T. SMITHMYER

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