21D2293380 CLIA NUMBER - WALGREENS #11951

Laboratory Demographics

  • CLIA Code: 21D2293380
  • Facility Name: WALGREENS #11951
  • Facility Address: 11085 CATHELL ROAD
    BERLIN, MD
    ZIP 21811
  • Facility Phone: 410 208-3811
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHELLE SEBOK
  • NPI Number: 1174544621
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2293380
LAB Type Pharmacy
Facility Name WALGREENS #11951
Street 11085 CATHELL ROAD
City BERLIN
State MD
ZIP 21811
Phone 410 208-3811
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/8/2023
Certificate Expiration Date 11/7/2025
Facility Type Pharmacy
Lab Director MICHELLE SEBOK

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