21D2301852 CLIA NUMBER - WALGREENS #17640

Laboratory Demographics

  • CLIA Code: 21D2301852
  • Facility Name: WALGREENS #17640
  • Facility Address: 22411 JEFFERSON BLVD
    SMITHSBURG, MD
    ZIP 21783
  • Facility Phone: 301 824-2211
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: VALERIE AZAFACK
  • NPI Number: 1275057135
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2301852
LAB Type Pharmacy
Facility Name WALGREENS #17640
Street 22411 JEFFERSON BLVD
City SMITHSBURG
State MD
ZIP 21783
Phone 301 824-2211
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/2/2024
Certificate Expiration Date 4/1/2026
Facility Type Pharmacy
Lab Director VALERIE AZAFACK

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This page was last updated on: 6/4/2025