31D2034941 CLIA NUMBER - WALGREENS#11982

Laboratory Demographics

  • CLIA Code: 31D2034941
  • Facility Name: WALGREENS#11982
  • Facility Address: 2 N VIRGINIA AVENUE
    PENNS GROVE, NJ
    ZIP 08069
  • Facility Phone: 856 299-0744
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NNEKA V. DIM
  • NPI Number: 1467661934
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 31D2034941
LAB Type Pharmacy
Facility Name WALGREENS#11982
Street 2 N VIRGINIA AVENUE
City PENNS GROVE
State NJ
ZIP 08069
Phone 856 299-0744
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/14/2025
Certificate Expiration Date 8/13/2027
Facility Type Pharmacy
Lab Director NNEKA V. DIM

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