21D2283806 CLIA NUMBER - MARYLAND CVS PHARMACY LLC DBA CVS/PHARMACY #03789

Laboratory Demographics

  • CLIA Code: 21D2283806
  • Facility Name: MARYLAND CVS PHARMACY LLC DBA CVS/PHARMACY #03789
  • Facility Address: 4840 MARLBORO PIKE
    CAPITOL HEIGHTS, MD
    ZIP 20743
  • Facility Phone: 301 669-0465
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHINYERE EMERUWA
  • NPI Number: 1366549859
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2283806
LAB Type Pharmacy
Facility Name MARYLAND CVS PHARMACY LLC DBA CVS/PHARMACY #03789
Street 4840 MARLBORO PIKE
City CAPITOL HEIGHTS
State MD
ZIP 20743
Phone 301 669-0465
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 CHINYERE EMERUWA

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