31D2122084 CLIA NUMBER - FANWOOD PHARMACY

Laboratory Demographics

  • CLIA Code: 31D2122084
  • Facility Name: FANWOOD PHARMACY
  • Facility Address: 45 SOUTH MARTINE AVE
    FANWOOD, NJ
    ZIP 07023
  • Facility Phone: 908 680-6936
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MITUL P. PATEL
  • NPI Number: 1851740401
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 31D2122084
LAB Type Pharmacy
Facility Name FANWOOD PHARMACY
Street 45 SOUTH MARTINE AVE
City FANWOOD
State NJ
ZIP 07023
Phone 908 680-6936
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/18/2024
Certificate Expiration Date 11/17/2026
Facility Type Pharmacy
Lab Director MITUL P. PATEL

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