31D2036313 CLIA NUMBER - WALGREENS#04162

Laboratory Demographics

  • CLIA Code: 31D2036313
  • Facility Name: WALGREENS#04162
  • Facility Address: 835 VAN HOUTEN AVE
    CLIFTON, NJ
    ZIP 07013
  • Facility Phone: 973 249-9280
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: STACY MATHEW
  • NPI Number: 1609881697
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 31D2036313
LAB Type Pharmacy
Facility Name WALGREENS#04162
Street 835 VAN HOUTEN AVE
City CLIFTON
State NJ
ZIP 07013
Phone 973 249-9280
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/17/2025
Certificate Expiration Date 2/16/2027
Facility Type Pharmacy
Lab Director STACY MATHEW

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