21D2283789 CLIA NUMBER - MARYLAND CVS PHARMACY LLC DBA CVS/ PHARMACY #01735

Laboratory Demographics

  • CLIA Code: 21D2283789
  • Facility Name: MARYLAND CVS PHARMACY LLC DBA CVS/ PHARMACY #01735
  • Facility Address: 7400 RITCHIE HWY
    GLEN BURNIE, MD
    ZIP 21061
  • Facility Phone: 401 770-3480
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KELLY C. MOORE
  • NPI Number: 1831295856
  • Taxonomy: 225100000X - Physical Therapist

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CLIA Record

Field Name Field Value
CLIA Number 21D2283789
LAB Type Pharmacy
Facility Name MARYLAND CVS PHARMACY LLC DBA CVS/ PHARMACY #01735
Street 7400 RITCHIE HWY
City GLEN BURNIE
State MD
ZIP 21061
Phone 401 770-3480
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 KELLY C. MOORE

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