21D2312940 CLIA NUMBER - WALGREENS #21369

Laboratory Demographics

  • CLIA Code: 21D2312940
  • Facility Name: WALGREENS #21369
  • Facility Address: 13415 PENNSYLVANIA AVE
    HAGERSTOWN, MD
    ZIP 21742
  • Facility Phone: 301 797-8038
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RUBY ANN HART
  • NPI Number: 1568890366
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2312940
LAB Type Pharmacy
Facility Name WALGREENS #21369
Street 13415 PENNSYLVANIA AVE
City HAGERSTOWN
State MD
ZIP 21742
Phone 301 797-8038
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/22/2024
Certificate Expiration Date 10/21/2026
Facility Type Pharmacy
Lab Director RUBY ANN HART

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