31D2035170 CLIA NUMBER - WALGREENS#12792

Laboratory Demographics

  • CLIA Code: 31D2035170
  • Facility Name: WALGREENS#12792
  • Facility Address: 350 PREAKNESS AVE
    PATERSON, NJ
    ZIP 07502
  • Facility Phone: 973 595-1075
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RITSA SKORDOS
  • NPI Number: 1659679280
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 31D2035170
LAB Type Pharmacy
Facility Name WALGREENS#12792
Street 350 PREAKNESS AVE
City PATERSON
State NJ
ZIP 07502
Phone 973 595-1075
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/14/2024
Certificate Expiration Date 12/13/2026
Facility Type Pharmacy
Lab Director RITSA SKORDOS

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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