21D2291032 CLIA NUMBER - WALGREENS #17917

Laboratory Demographics

  • CLIA Code: 21D2291032
  • Facility Name: WALGREENS #17917
  • Facility Address: 12701 LAUREL BOWIE RD
    LAUREL, MD
    ZIP 20708
  • Facility Phone: 240 456-0301
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AEAD ODEH
  • NPI Number: 1083139547
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2291032
LAB Type Pharmacy
Facility Name WALGREENS #17917
Street 12701 LAUREL BOWIE RD
City LAUREL
State MD
ZIP 20708
Phone 240 456-0301
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 AEAD ODEH

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