21D2290992 CLIA NUMBER - WALGREENS #17333

Laboratory Demographics

  • CLIA Code: 21D2290992
  • Facility Name: WALGREENS #17333
  • Facility Address: 1000 KEY PKWY
    FREDERICK, MD
    ZIP 21702
  • Facility Phone: 301 624-0000
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PRIMROSE R. DATOC
  • NPI Number: 1881110534
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 21D2290992
LAB Type Pharmacy
Facility Name WALGREENS #17333
Street 1000 KEY PKWY
City FREDERICK
State MD
ZIP 21702
Phone 301 624-0000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/4/2025
Certificate Expiration Date 10/3/2027
Facility Type Pharmacy
Lab Director PRIMROSE R. DATOC

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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