21D2283797 CLIA NUMBER - MARYLAND CVS PHARMACY LLC DBA CVS PHARMACY #03043

Laboratory Demographics

  • CLIA Code: 21D2283797
  • Facility Name: MARYLAND CVS PHARMACY LLC DBA CVS PHARMACY #03043
  • Facility Address: 1500 RITCHIE HWY SWC
    ARNOLD, MD
    ZIP 21012
  • Facility Phone: 401 770-3480
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: OLUJIMI ODUSANYA
  • NPI Number: 1285035204
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2283797
LAB Type Pharmacy
Facility Name MARYLAND CVS PHARMACY LLC DBA CVS PHARMACY #03043
Street 1500 RITCHIE HWY SWC
City ARNOLD
State MD
ZIP 21012
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 OLUJIMI ODUSANYA

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