21D2293323 CLIA NUMBER - WALGREENS #19312

Laboratory Demographics

  • CLIA Code: 21D2293323
  • Facility Name: WALGREENS #19312
  • Facility Address: 6130 BALTIMORE AVE
    RIVERDALE, MD
    ZIP 20737
  • Facility Phone: 301 699-5004
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ISSA ABDURAHMAN
  • NPI Number: 1225553704
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2293323
LAB Type Pharmacy
Facility Name WALGREENS #19312
Street 6130 BALTIMORE AVE
City RIVERDALE
State MD
ZIP 20737
Phone 301 699-5004
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/7/2023
Certificate Expiration Date 11/6/2025
Facility Type Pharmacy
Lab Director ISSA ABDURAHMAN

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