21D2283763 CLIA NUMBER - MARYLAND CVS PHARMACY LLC DBA CVS PHARMACY #10094

Laboratory Demographics

  • CLIA Code: 21D2283763
  • Facility Name: MARYLAND CVS PHARMACY LLC DBA CVS PHARMACY #10094
  • Facility Address: 5405 LYNX LANE
    COLUMBIA, MD
    ZIP 21044
  • Facility Phone: 410 740-7273
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AHDIEH ROUGHANI
  • NPI Number: 1710386602
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2283763
LAB Type Pharmacy
Facility Name MARYLAND CVS PHARMACY LLC DBA CVS PHARMACY #10094
Street 5405 LYNX LANE
City COLUMBIA
State MD
ZIP 21044
Phone 410 740-7273
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/13/2025
Certificate Expiration Date 6/12/2027
Facility Type Pharmacy
Lab Director AHDIEH ROUGHANI

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