21D2248345 CLIA NUMBER - MAIN STREET PHARMACY

Laboratory Demographics

  • CLIA Code: 21D2248345
  • Facility Name: MAIN STREET PHARMACY
  • Facility Address: 667 MAIN STREET
    LAUREL, MD
    ZIP 20707
  • Facility Phone: 301 317-3838
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: THAKKAR ALI
  • NPI Number: 1477558112
  • Taxonomy: 183500000X - Pharmacist

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CLIA Record

Field Name Field Value
CLIA Number 21D2248345
LAB Type Pharmacy
Facility Name MAIN STREET PHARMACY
Street 667 MAIN STREET
City LAUREL
State MD
ZIP 20707
Phone 301 317-3838
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/13/2024
Certificate Expiration Date 1/12/2026
Facility Type Pharmacy
Lab Director THAKKAR ALI

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