21D2283790 CLIA NUMBER - MARYLAND CVS PHARMACY LLC DBA CVS/ PHARMACY #02230

Laboratory Demographics

  • CLIA Code: 21D2283790
  • Facility Name: MARYLAND CVS PHARMACY LLC DBA CVS/ PHARMACY #02230
  • Facility Address: 2040 ROSEMONT AVE
    FREDERICK, MD
    ZIP 21702
  • Facility Phone: 401 770-3480
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JAMES PAYNE
  • NPI Number: 1316044803
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2283790
LAB Type Pharmacy
Facility Name MARYLAND CVS PHARMACY LLC DBA CVS/ PHARMACY #02230
Street 2040 ROSEMONT AVE
City FREDERICK
State MD
ZIP 21702
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 JAMES PAYNE

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