21D2285285 CLIA NUMBER - MARYLAND CVS LLC DBA CVS/PHARMACY #10588

Laboratory Demographics

  • CLIA Code: 21D2285285
  • Facility Name: MARYLAND CVS LLC DBA CVS/PHARMACY #10588
  • Facility Address: 4701 WILKENS AVE
    CATONSVILLE, MD
    ZIP 21228
  • Facility Phone: 443 297-3097
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DEIDRE PETERS
  • NPI Number: 1699324806
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2285285
LAB Type Pharmacy
Facility Name MARYLAND CVS LLC DBA CVS/PHARMACY #10588
Street 4701 WILKENS AVE
City CATONSVILLE
State MD
ZIP 21228
Phone 443 297-3097
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/11/2025
Certificate Expiration Date 7/10/2027
Facility Type Pharmacy
Lab Director DEIDRE PETERS

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