21D2290552 CLIA NUMBER - WALGREENS #19249

Laboratory Demographics

  • CLIA Code: 21D2290552
  • Facility Name: WALGREENS #19249
  • Facility Address: 1005 BAY RIDGE AVENUE
    ANNAPOLIS, MD
    ZIP 21403
  • Facility Phone: 410 267-8600
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MADISON WALBOM
  • NPI Number: 1013431949
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2290552
LAB Type Pharmacy
Facility Name WALGREENS #19249
Street 1005 BAY RIDGE AVENUE
City ANNAPOLIS
State MD
ZIP 21403
Phone 410 267-8600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/27/2025
Certificate Expiration Date 9/26/2027
Facility Type Pharmacy
Lab Director MADISON WALBOM

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