31D2035915 CLIA NUMBER - WALGREENS#13706

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Laboratory Demographics

CLIA Number: 31D2035915

Facility Name: WALGREENS#13706

Facility Address:
110 MOUNTAIN BLVD EXT
WARREN, NJ
ZIP 07059
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Facility Phone Number: 732 907-6745

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1225270275

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	31D2035915
LAB Type	Pharmacy
Facility Name	WALGREENS#13706
Street	110 MOUNTAIN BLVD EXT
City	WARREN
State	NJ
ZIP	07059
Phone	732 907-6745
CertificateType	4
CertificateEffectiveDate	9/8/2023
CertificateExpirationDate	9/7/2025
FacilityType	Waiver

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