31D2035142 CLIA NUMBER - WALGREENS#12079

Laboratory Demographics

  • CLIA Code: 31D2035142
  • Facility Name: WALGREENS#12079
  • Facility Address: 597 WASHINGTON AVENUE
    BELLEVILLE, NJ
    ZIP 07109
  • Facility Phone: 973 450-0138
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: GIA HONG
  • NPI Number: 1356617112
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 31D2035142
LAB Type Pharmacy
Facility Name WALGREENS#12079
Street 597 WASHINGTON AVENUE
City BELLEVILLE
State NJ
ZIP 07109
Phone 973 450-0138
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/28/2023
Certificate Expiration Date 7/27/2025
Facility Type Pharmacy
Lab Director GIA HONG

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This page was last updated on: 6/4/2025