21D2295522 CLIA NUMBER - WALGREENS #19336

Laboratory Demographics

  • CLIA Code: 21D2295522
  • Facility Name: WALGREENS #19336
  • Facility Address: 9810 APOLLO DRIVE
    LARGO, MD
    ZIP 20774
  • Facility Phone: 301 322-9027
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JUSTIN M. LUCKADUE
  • NPI Number: 1588189062
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2295522
LAB Type Pharmacy
Facility Name WALGREENS #19336
Street 9810 APOLLO DRIVE
City LARGO
State MD
ZIP 20774
Phone 301 322-9027
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/13/2023
Certificate Expiration Date 12/12/2025
Facility Type Pharmacy
Lab Director JUSTIN M. LUCKADUE

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