21D2096932 CLIA NUMBER - WALGREENS #15958

Laboratory Demographics

  • CLIA Code: 21D2096932
  • Facility Name: WALGREENS #15958
  • Facility Address: 13403 VOLVO WAY MEDICAL
    HAGERSTOWN, MD
    ZIP 21742
  • Facility Phone: 240 500-3764
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ELIZABETH NGUYEN
  • NPI Number: 1093148124
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2096932
LAB Type Pharmacy
Facility Name WALGREENS #15958
Street 13403 VOLVO WAY MEDICAL
City HAGERSTOWN
State MD
ZIP 21742
Phone 240 500-3764
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/7/2024
Certificate Expiration Date 1/6/2026
Facility Type Pharmacy
Lab Director ELIZABETH NGUYEN

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