31D2035172 CLIA NUMBER - WALGREENS#13702

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Laboratory Demographics

CLIA Number: 31D2035172

Facility Name: WALGREENS#13702

Facility Address:
397 ROUTE 46 W
FAIRFIELD, NJ
ZIP 07004
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Facility Phone Number: 862 210-3980

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1629210687

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	31D2035172
LAB Type	Pharmacy
Facility Name	WALGREENS#13702
Street	397 ROUTE 46 W
City	FAIRFIELD
State	NJ
ZIP	07004
Phone	862 210-3980
CertificateType	4
CertificateEffectiveDate	1/12/2024
CertificateExpirationDate	1/11/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024