21D2291004 CLIA NUMBER - WALGREENS #19086

Laboratory Demographics

  • CLIA Code: 21D2291004
  • Facility Name: WALGREENS #19086
  • Facility Address: 7535 HOLABIRD AVENUE
    BALTIMORE, MD
    ZIP 21222
  • Facility Phone: 410 282-4020
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CRYSTAL M. SANNIEZ
  • NPI Number: 1801312574
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2291004
LAB Type Pharmacy
Facility Name WALGREENS #19086
Street 7535 HOLABIRD AVENUE
City BALTIMORE
State MD
ZIP 21222
Phone 410 282-4020
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 CRYSTAL M. SANNIEZ

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