31D2036882 CLIA NUMBER - WALGREENS#09503

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Laboratory Demographics

CLIA Number: 31D2036882

Facility Name: WALGREENS#09503

Facility Address:
879 W BAY AVE
BARNEGAT, NJ
ZIP 08005
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Facility Phone Number: 609 698-7035

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1467667055

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	31D2036882
LAB Type	Pharmacy
Facility Name	WALGREENS#09503
Street	879 W BAY AVE
City	BARNEGAT
State	NJ
ZIP	08005
Phone	609 698-7035
CertificateType	4
CertificateEffectiveDate	5/25/2023
CertificateExpirationDate	5/24/2025
FacilityType	Waiver

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