21D2285365 CLIA NUMBER - MARYLAND CVS PHARMACY LLC DBA CVS/PHARMACY #01797

Laboratory Demographics

  • CLIA Code: 21D2285365
  • Facility Name: MARYLAND CVS PHARMACY LLC DBA CVS/PHARMACY #01797
  • Facility Address: 19594 FISHER AVE
    POOLESVILLE, MD
    ZIP 20837
  • Facility Phone: 301 349-9805
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ROBERT MALETTA
  • NPI Number: 1689778524
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2285365
LAB Type Pharmacy
Facility Name MARYLAND CVS PHARMACY LLC DBA CVS/PHARMACY #01797
Street 19594 FISHER AVE
City POOLESVILLE
State MD
ZIP 20837
Phone 301 349-9805
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 ROBERT MALETTA

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