21D2293773 CLIA NUMBER - WALGREENS #19380

Laboratory Demographics

  • CLIA Code: 21D2293773
  • Facility Name: WALGREENS #19380
  • Facility Address: 6970 CRESTWOOD BLVD
    FREDERICK, MD
    ZIP 21703
  • Facility Phone: 301 682-9158
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SHEETAL P. JAILWALA
  • NPI Number: 1093230583
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2293773
LAB Type Pharmacy
Facility Name WALGREENS #19380
Street 6970 CRESTWOOD BLVD
City FREDERICK
State MD
ZIP 21703
Phone 301 682-9158
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/15/2023
Certificate Expiration Date 11/14/2025
Facility Type Pharmacy
Lab Director SHEETAL P. JAILWALA

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