31D2036540 CLIA NUMBER - WALGREENS#11027

Laboratory Demographics

  • CLIA Code: 31D2036540
  • Facility Name: WALGREENS#11027
  • Facility Address: 230 SOUTH BROADWAY
    PENNSVILLE, NJ
    ZIP 08070
  • Facility Phone: 856 678-2224
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JACLYN LO PICCOLO
  • NPI Number: 1053337345
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 31D2036540
LAB Type Pharmacy
Facility Name WALGREENS#11027
Street 230 SOUTH BROADWAY
City PENNSVILLE
State NJ
ZIP 08070
Phone 856 678-2224
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/28/2025
Certificate Expiration Date 7/27/2027
Facility Type Pharmacy
Lab Director JACLYN LO PICCOLO

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