31D2034933 CLIA NUMBER - WALGREENS #05987

Laboratory Demographics

  • CLIA Code: 31D2034933
  • Facility Name: WALGREENS #05987
  • Facility Address: 4296 RT 130
    WILLINGBORO, NJ
    ZIP 08046
  • Facility Phone: 609 871-9017
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DANA CHIPPI
  • NPI Number: 1902811896
  • Taxonomy: 333600000X - Pharmacy

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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
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/5/2025
Certificate Expiration Date 2/4/2027
Facility Type Pharmacy
Lab Director DANA CHIPPI

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