21D2293327 CLIA NUMBER - WALGREENS #17859

Laboratory Demographics

  • CLIA Code: 21D2293327
  • Facility Name: WALGREENS #17859
  • Facility Address: 5741 SILVER HILL RD
    DISTRICT HEIGHTS, MD
    ZIP 20747
  • Facility Phone: 301 736-0904
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SUEBANG KENMATIO
  • NPI Number: 1013763754
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 21D2293327
LAB Type Pharmacy
Facility Name WALGREENS #17859
Street 5741 SILVER HILL RD
City DISTRICT HEIGHTS
State MD
ZIP 20747
Phone 301 736-0904
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 SUEBANG KENMATIO

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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