21D2283770 CLIA NUMBER - MARYLAND CVS PHARMACY LLC DBA CVS PHARMACY #01461

Laboratory Demographics

  • CLIA Code: 21D2283770
  • Facility Name: MARYLAND CVS PHARMACY LLC DBA CVS PHARMACY #01461
  • Facility Address: 15600 COLUMBIA PIKE
    BURTONSVILLE, MD
    ZIP 20866
  • Facility Phone: (301) 421-9060
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SHANELLE L. DEBRAUX
  • NPI Number: 1396849220
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2283770
LAB Type Pharmacy
Facility Name MARYLAND CVS PHARMACY LLC DBA CVS PHARMACY #01461
Street 15600 COLUMBIA PIKE
City BURTONSVILLE
State MD
ZIP 20866
Phone 3014219060
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 SHANELLE L. DEBRAUX

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This page was last updated on: 5/18/2026