31D2035174 CLIA NUMBER - WALGREENS#11804

Laboratory Demographics

  • CLIA Code: 31D2035174
  • Facility Name: WALGREENS#11804
  • Facility Address: 241 N WASHINGTON AVE
    BERGENFIELD, NJ
    ZIP 07621
  • Facility Phone: 201 384-0964
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SLAVA KACHEROV
  • NPI Number: 1386872976
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 31D2035174
LAB Type Pharmacy
Facility Name WALGREENS#11804
Street 241 N WASHINGTON AVE
City BERGENFIELD
State NJ
ZIP 07621
Phone 201 384-0964
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 SLAVA KACHEROV

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