21D2290998 CLIA NUMBER - WALGREENS #05331

Laboratory Demographics

  • CLIA Code: 21D2290998
  • Facility Name: WALGREENS #05331
  • Facility Address: 8050 LIBERTY RD
    BALTIMORE, MD
    ZIP 21244
  • Facility Phone: 410 496-2117
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: VI B. CAO
  • NPI Number: 1407861685
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2290998
LAB Type Pharmacy
Facility Name WALGREENS #05331
Street 8050 LIBERTY RD
City BALTIMORE
State MD
ZIP 21244
Phone 410 496-2117
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/4/2023
Certificate Expiration Date 10/3/2025
Facility Type Pharmacy
Lab Director VI B. CAO

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