21D2290563 CLIA NUMBER - WALGREENS #17944

Laboratory Demographics

  • CLIA Code: 21D2290563
  • Facility Name: WALGREENS #17944
  • Facility Address: 110 MITCHELLS CHANCE RD
    EDGEWATER, MD
    ZIP 21037
  • Facility Phone: 410 956-9411
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DEBORAH JORGENSEN
  • NPI Number: 1013431717
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2290563
LAB Type Pharmacy
Facility Name WALGREENS #17944
Street 110 MITCHELLS CHANCE RD
City EDGEWATER
State MD
ZIP 21037
Phone 410 956-9411
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 DEBORAH JORGENSEN

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