31D2036246 CLIA NUMBER - WALGREENS#06161

Laboratory Demographics

  • CLIA Code: 31D2036246
  • Facility Name: WALGREENS#06161
  • Facility Address: 100 BROADWAY
    ELMWOOD PARK, NJ
    ZIP 07407
  • Facility Phone: 201 796-0204
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TAMISHA CHARLES-CACHO
  • NPI Number: 1710992797
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 31D2036246
LAB Type Pharmacy
Facility Name WALGREENS#06161
Street 100 BROADWAY
City ELMWOOD PARK
State NJ
ZIP 07407
Phone 201 796-0204
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/25/2025
Certificate Expiration Date 3/24/2027
Facility Type Pharmacy
Lab Director TAMISHA CHARLES-CACHO

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