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21D2291001 CLIA NUMBER - WALGREENS #19471

Laboratory Demographics

CLIA Number: 21D2291001

Facility Name: WALGREENS #19471

Facility Address:
40955 MERCHANT LN
LEONARDTOWN, MD
ZIP 20650
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Facility Phone Number: 301 475-7212

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1457875304

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name Field Value
CLIA Number 21D2291001
LAB Type Pharmacy
Facility Name WALGREENS #19471
Street 40955 MERCHANT LN
City LEONARDTOWN
State MD
ZIP 20650
Phone 301 475-7212
CertificateType 4
CertificateEffectiveDate 10/4/2023
CertificateExpirationDate 10/3/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024