21D2283795 CLIA NUMBER - MARYLAND CVS PHARMACY LLC DBA CVS PHARMACY #02779

Laboratory Demographics

  • CLIA Code: 21D2283795
  • Facility Name: MARYLAND CVS PHARMACY LLC DBA CVS PHARMACY #02779
  • Facility Address: 503 S CHERRY GROVE AVE
    ANNAPOLIS, MD
    ZIP 21401
  • Facility Phone: 443 482-3981
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SABURI O. SONEKAN
  • NPI Number: 1396849246
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 21D2283795
LAB Type Pharmacy
Facility Name MARYLAND CVS PHARMACY LLC DBA CVS PHARMACY #02779
Street 503 S CHERRY GROVE AVE
City ANNAPOLIS
State MD
ZIP 21401
Phone 443 482-3981
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 SABURI O. SONEKAN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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