31D2036814 CLIA NUMBER - WALGREENS#04059

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Laboratory Demographics

CLIA Number: 31D2036814

Facility Name: WALGREENS#04059

Facility Address:
100 WHITE HORSE PIKE N
MAGNOLIA, NJ
ZIP 08049
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Facility Phone Number: 856 782-2237

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1437164423

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	31D2036814
LAB Type	Pharmacy
Facility Name	WALGREENS#04059
Street	100 WHITE HORSE PIKE N
City	MAGNOLIA
State	NJ
ZIP	08049
Phone	856 782-2237
CertificateType	4
CertificateEffectiveDate	5/13/2023
CertificateExpirationDate	5/12/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024