21D2291022 CLIA NUMBER - WALGREENS #18052

Laboratory Demographics

CLIA Number: 21D2291022

Facility Name: WALGREENS #18052

Facility Address:
92 SOUDER ROAD
BRUNSWICK, MD
ZIP 21716
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Facility Phone Number: 301 834-8100

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1346765815

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	21D2291022
LAB Type	Pharmacy
Facility Name	WALGREENS #18052
Street	92 SOUDER ROAD
City	BRUNSWICK
State	MD
ZIP	21716
Phone	301 834-8100
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