21D2292925 CLIA NUMBER - WALGREENS #15130

Laboratory Demographics

  • CLIA Code: 21D2292925
  • Facility Name: WALGREENS #15130
  • Facility Address: 10410 YORK RD
    COCKEYSVILLE, MD
    ZIP 21030
  • Facility Phone: 410 628-8390
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JEFFREY MAURIN
  • NPI Number: 1588097992
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2292925
LAB Type Pharmacy
Facility Name WALGREENS #15130
Street 10410 YORK RD
City COCKEYSVILLE
State MD
ZIP 21030
Phone 410 628-8390
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/1/2023
Certificate Expiration Date 10/31/2025
Facility Type Pharmacy
Lab Director JEFFREY MAURIN

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