21D2209501 CLIA NUMBER - NORTHSIDE PHARMACY

Laboratory Demographics

  • CLIA Code: 21D2209501
  • Facility Name: NORTHSIDE PHARMACY
  • Facility Address: 707 BRIDGE STREET
    ELKTON, MD
    ZIP 21921
  • Facility Phone: 410 398-3784
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DAVID AYRES
  • NPI Number: 1871737304
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2209501
LAB Type Pharmacy
Facility Name NORTHSIDE PHARMACY
Street 707 BRIDGE STREET
City ELKTON
State MD
ZIP 21921
Phone 410 398-3784
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/14/2025
Certificate Expiration Date 1/13/2027
Facility Type Pharmacy
Lab Director DAVID AYRES

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