21D2226559 CLIA NUMBER - MARYLAND CVS PHARMACY LLC DBA CVS/PHARMACY #03047

Laboratory Demographics

CLIA Number: 21D2226559

Facility Name: MARYLAND CVS PHARMACY LLC DBA CVS/PHARMACY #03047

Facility Address:
8601 MARTIN LUTHER KING JR HWY
LANHAM, MD
ZIP 20706
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Facility Phone Number: 866 389-2727

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1851348536

Taxonomy: 261QM0801X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	21D2226559
LAB Type	Pharmacy
Facility Name	MARYLAND CVS PHARMACY LLC DBA CVS/PHARMACY #03047
Street	8601 MARTIN LUTHER KING JR HWY
City	LANHAM
State	MD
ZIP	20706
Phone	866 389-2727
CertificateType	4
CertificateEffectiveDate	6/2/2023
CertificateExpirationDate	6/1/2025
FacilityType	Waiver

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