21D2220671 CLIA NUMBER - MARYLAND CVS PHARMACY LLC DBA CVS/PHARMACY #16389

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Laboratory Demographics

CLIA Number: 21D2220671

Facility Name: MARYLAND CVS PHARMACY LLC DBA CVS/PHARMACY #16389

Facility Address:
200 MALCOLM DR
WESTMINSTER, MD
ZIP 21157
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Facility Phone Number: 401 770-6431

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1376758110

Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

CLIA Record

Field Name	Field Value
CLIA Number	21D2220671
LAB Type	Pharmacy
Facility Name	MARYLAND CVS PHARMACY LLC DBA CVS/PHARMACY #16389
Street	200 MALCOLM DR
City	WESTMINSTER
State	MD
ZIP	21157
Phone	401 770-6431
CertificateType	4
CertificateEffectiveDate	4/14/2023
CertificateExpirationDate	4/13/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024