31D2035141 CLIA NUMBER - WALGREENS#13721

Laboratory Demographics

  • CLIA Code: 31D2035141
  • Facility Name: WALGREENS#13721
  • Facility Address: 600 MYRTLE AVENUE
    BOONTON, NJ
    ZIP 07005
  • Facility Phone: 973 939-9021
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALI R. HASSANZADEH
  • NPI Number: 1902048994
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 31D2035141
LAB Type Pharmacy
Facility Name WALGREENS#13721
Street 600 MYRTLE AVENUE
City BOONTON
State NJ
ZIP 07005
Phone 973 939-9021
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/10/2025
Certificate Expiration Date 8/9/2027
Facility Type Pharmacy
Lab Director ALI R. HASSANZADEH

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