31D2035044 CLIA NUMBER - WALGREENS#07121

Laboratory Demographics

  • CLIA Code: 31D2035044
  • Facility Name: WALGREENS#07121
  • Facility Address: 404 RTE 73 SOUTH
    EVESHAM, NJ
    ZIP 08053
  • Facility Phone: 856 988-6164
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOHN S. RUTKOWSKI
  • NPI Number: 1346255239
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 31D2035044
LAB Type Pharmacy
Facility Name WALGREENS#07121
Street 404 RTE 73 SOUTH
City EVESHAM
State NJ
ZIP 08053
Phone 856 988-6164
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/29/2025
Certificate Expiration Date 9/28/2027
Facility Type Pharmacy
Lab Director JOHN S. RUTKOWSKI

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