21D2293331 CLIA NUMBER - WALGREENS #17610

Laboratory Demographics

  • CLIA Code: 21D2293331
  • Facility Name: WALGREENS #17610
  • Facility Address: 1230 BAY DALE DRIVE
    ARNOLD, MD
    ZIP 21012
  • Facility Phone: 410 757-0027
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARWA ELFDALY
  • NPI Number: 1316461114
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2293331
LAB Type Physician Office
Facility Name WALGREENS #17610
Street 1230 BAY DALE DRIVE
City ARNOLD
State MD
ZIP 21012
Phone 410 757-0027
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 Physician Office
Lab Director MARWA ELFDALY

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