21D2190727 CLIA NUMBER - BROADNECK PHARMACY

Laboratory Demographics

  • CLIA Code: 21D2190727
  • Facility Name: BROADNECK PHARMACY
  • Facility Address: 269 PENINSULA FARM RD
    ARNOLD, MD
    ZIP 21012
  • Facility Phone: 410 544-3733
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARCUS J. LACHEPELLE
  • NPI Number: 1629010483
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2190727
LAB Type Pharmacy
Facility Name BROADNECK PHARMACY
Street 269 PENINSULA FARM RD
City ARNOLD
State MD
ZIP 21012
Phone 410 544-3733
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/19/2024
Certificate Expiration Date 8/18/2026
Facility Type Pharmacy
Lab Director MARCUS J. LACHEPELLE

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