21D2283799 CLIA NUMBER - MARYLAND CVS PHARMACY LLC DBA CVS/PHARMACY #04018

Laboratory Demographics

  • CLIA Code: 21D2283799
  • Facility Name: MARYLAND CVS PHARMACY LLC DBA CVS/PHARMACY #04018
  • Facility Address: 228 MOUNTAIN RD
    FALLSTON, MD
    ZIP 21047
  • Facility Phone: 410 877-7887
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BERNICE AMO-ADADE
  • NPI Number: 1386747046
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2283799
LAB Type Pharmacy
Facility Name MARYLAND CVS PHARMACY LLC DBA CVS/PHARMACY #04018
Street 228 MOUNTAIN RD
City FALLSTON
State MD
ZIP 21047
Phone 410 877-7887
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 BERNICE AMO-ADADE

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