21D2073603 CLIA NUMBER - WALGREENS #15284

Laboratory Demographics

  • CLIA Code: 21D2073603
  • Facility Name: WALGREENS #15284
  • Facility Address: 900 N WASHINGTON STREET STE 1
    BALTIMORE, MD
    ZIP 21205
  • Facility Phone: 410 522-5639
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NICOLE S. LAZOR
  • NPI Number: 1366879504
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2073603
LAB Type Pharmacy
Facility Name WALGREENS #15284
Street 900 N WASHINGTON STREET STE 1
City BALTIMORE
State MD
ZIP 21205
Phone 410 522-5639
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/2/2024
Certificate Expiration Date 4/1/2026
Facility Type Pharmacy
Lab Director NICOLE S. LAZOR

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