31D2036315 CLIA NUMBER - WALGREENS #05005

Laboratory Demographics

  • CLIA Code: 31D2036315
  • Facility Name: WALGREENS #05005
  • Facility Address: 639 EAST 18TH STREET
    PATERSON, NJ
    ZIP 07501
  • Facility Phone: 973 925-8885
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: HISHAM AHMED
  • NPI Number: 1982619979
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 31D2036315
LAB Type Pharmacy
Facility Name WALGREENS #05005
Street 639 EAST 18TH STREET
City PATERSON
State NJ
ZIP 07501
Phone 973 925-8885
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/21/2024
Certificate Expiration Date 6/20/2026
Facility Type Pharmacy
Lab Director HISHAM AHMED

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This page was last updated on: 6/4/2025