31D2052142 CLIA NUMBER - WALGREENS#12442

Laboratory Demographics

  • CLIA Code: 31D2052142
  • Facility Name: WALGREENS#12442
  • Facility Address: 3508 JOHN F KENNEDY BLVD
    UNION CITY, NJ
    ZIP 07087
  • Facility Phone: 201 864-9129
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHAEL GONZALEZ
  • NPI Number: 1609144377
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 31D2052142
LAB Type Pharmacy
Facility Name WALGREENS#12442
Street 3508 JOHN F KENNEDY BLVD
City UNION CITY
State NJ
ZIP 07087
Phone 201 864-9129
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/14/2024
Certificate Expiration Date 10/13/2026
Facility Type Pharmacy
Lab Director MICHAEL GONZALEZ

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