21D2298199 CLIA NUMBER - EDENRX PHARMACY LLC

Laboratory Demographics

  • CLIA Code: 21D2298199
  • Facility Name: EDENRX PHARMACY LLC
  • Facility Address: 3819 HARBOR RD UNIT 104
    CHESAPEAKE BEACH, MD
    ZIP 20732
  • Facility Phone: 443 906-3336
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TOLULOPE DEHINBO
  • NPI Number: 1992406292
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2298199
LAB Type Pharmacy
Facility Name EDENRX PHARMACY LLC
Street 3819 HARBOR RD UNIT 104
City CHESAPEAKE BEACH
State MD
ZIP 20732
Phone 443 906-3336
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/30/2024
Certificate Expiration Date 1/29/2026
Facility Type Pharmacy
Lab Director TOLULOPE DEHINBO

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