21D2284967 CLIA NUMBER - MARYLAND CVS PHARMACY LLC DBA CVS/PHARMACY #02010

Laboratory Demographics

  • CLIA Code: 21D2284967
  • Facility Name: MARYLAND CVS PHARMACY LLC DBA CVS/PHARMACY #02010
  • Facility Address: 1102 ANNAPOLIS ROAD
    ODENTON, MD
    ZIP 21113
  • Facility Phone: 410 674-8338
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AUSTIN A. FORCHAP
  • NPI Number: 1780781278
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2284967
LAB Type Pharmacy
Facility Name MARYLAND CVS PHARMACY LLC DBA CVS/PHARMACY #02010
Street 1102 ANNAPOLIS ROAD
City ODENTON
State MD
ZIP 21113
Phone 410 674-8338
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/3/2025
Certificate Expiration Date 7/2/2027
Facility Type Pharmacy
Lab Director AUSTIN A. FORCHAP

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