21D2283765 CLIA NUMBER - MARYLAND CVS PHARMACY LLC DBA CVS PHARMACY #06614

Laboratory Demographics

  • CLIA Code: 21D2283765
  • Facility Name: MARYLAND CVS PHARMACY LLC DBA CVS PHARMACY #06614
  • Facility Address: 1008 PULASKI HWY
    HAVRE DE GRACE, MD
    ZIP 21078
  • Facility Phone: 410 939-6427
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALAAELDIN ABDELRAHMAN
  • NPI Number: 1730415795
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2283765
LAB Type Pharmacy
Facility Name MARYLAND CVS PHARMACY LLC DBA CVS PHARMACY #06614
Street 1008 PULASKI HWY
City HAVRE DE GRACE
State MD
ZIP 21078
Phone 410 939-6427
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 ALAAELDIN ABDELRAHMAN

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