31D2036816 CLIA NUMBER - WALGREENS#03379

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Laboratory Demographics

CLIA Number: 31D2036816

Facility Name: WALGREENS#03379

Facility Address:
61 FERRY ST
NEWARK, NJ
ZIP 07105
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Facility Phone Number: 973 465-0482

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1356356349

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	31D2036816
LAB Type	Pharmacy
Facility Name	WALGREENS#03379
Street	61 FERRY ST
City	NEWARK
State	NJ
ZIP	07105
Phone	973 465-0482
CertificateType	4
CertificateEffectiveDate	3/29/2023
CertificateExpirationDate	3/28/2025
FacilityType	Waiver

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