31D2034933 CLIA NUMBER - WALGREENS #05987

Laboratory Demographics

CLIA Number: 31D2034933

Facility Name: WALGREENS #05987

Facility Address:
4296 RT 130
WILLINGBORO, NJ
ZIP 08046
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Facility Phone Number: 609 871-9017

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1902811896

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name Field Value
CLIA Number 31D2034933
LAB Type Pharmacy
Facility Name WALGREENS #05987
Street 4296 RT 130
City WILLINGBORO
State NJ
ZIP 08046
Phone 609 871-9017
CertificateType 4
CertificateEffectiveDate 2/5/2023
CertificateExpirationDate 2/4/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024