21D2284968 CLIA NUMBER - MARYLAND CVS PHARMACY LLC DBA CVS/PHARMACY #04274

Laboratory Demographics

  • CLIA Code: 21D2284968
  • Facility Name: MARYLAND CVS PHARMACY LLC DBA CVS/PHARMACY #04274
  • Facility Address: 4140 JOPPA ROAD
    BALTIMORE, MD
    ZIP 21236
  • Facility Phone: 410 256-2844
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALEXANDREA MACLEOD
  • NPI Number: 1740383405
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2284968
LAB Type Pharmacy
Facility Name MARYLAND CVS PHARMACY LLC DBA CVS/PHARMACY #04274
Street 4140 JOPPA ROAD
City BALTIMORE
State MD
ZIP 21236
Phone 410 256-2844
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 ALEXANDREA MACLEOD

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