31D2036538 CLIA NUMBER - WALGREENS#06741

Laboratory Demographics

  • CLIA Code: 31D2036538
  • Facility Name: WALGREENS#06741
  • Facility Address: 180 BRIDGETON PIKE
    MANTUA, NJ
    ZIP 08051
  • Facility Phone: 856 468-9530
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KELLIE I. MCCLOSKEY
  • NPI Number: 1255346144
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 31D2036538
LAB Type Pharmacy
Facility Name WALGREENS#06741
Street 180 BRIDGETON PIKE
City MANTUA
State NJ
ZIP 08051
Phone 856 468-9530
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/12/2025
Certificate Expiration Date 10/11/2027
Facility Type Pharmacy
Lab Director KELLIE I. MCCLOSKEY

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