21D2290995 CLIA NUMBER - WALGREENS #19043

Laboratory Demographics

  • CLIA Code: 21D2290995
  • Facility Name: WALGREENS #19043
  • Facility Address: 3463 SWEET AIR ROAD
    PHOENIX, MD
    ZIP 21131
  • Facility Phone: 410 666-8220
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LAURA A. MAURIN
  • NPI Number: 1154845980
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2290995
LAB Type Pharmacy
Facility Name WALGREENS #19043
Street 3463 SWEET AIR ROAD
City PHOENIX
State MD
ZIP 21131
Phone 410 666-8220
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 LAURA A. MAURIN

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