31D2036872 CLIA NUMBER - WALGREENS#05201

Laboratory Demographics

  • CLIA Code: 31D2036872
  • Facility Name: WALGREENS#05201
  • Facility Address: 216 RTE 36
    WEST LONG BRANCH, NJ
    ZIP 07764
  • Facility Phone: 732 728-2283
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: HILDANIA TAVERAS
  • NPI Number: 1447265335
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 31D2036872
LAB Type Pharmacy
Facility Name WALGREENS#05201
Street 216 RTE 36
City WEST LONG BRANCH
State NJ
ZIP 07764
Phone 732 728-2283
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/17/2025
Certificate Expiration Date 6/16/2027
Facility Type Pharmacy
Lab Director HILDANIA TAVERAS

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