31D2194917 CLIA NUMBER - WALGREENS # 19396

Laboratory Demographics

  • CLIA Code: 31D2194917
  • Facility Name: WALGREENS # 19396
  • Facility Address: 231 PROSPECT STREET
    SOUTH RIVER, NJ
    ZIP 08882
  • Facility Phone: 267 626-9592
  • Facility Type: Other - COVID 19 TESTING
  • Facility Type: Waiver
  • Lab Director: REBECCA SUN
  • NPI Number: 1649795253
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 31D2194917
LAB Type Other - COVID 19 TESTING
Facility Name WALGREENS # 19396
Street 231 PROSPECT STREET
City SOUTH RIVER
State NJ
ZIP 08882
Phone 267 626-9592
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/5/2024
Certificate Expiration Date 10/4/2026
Facility Type Other - COVID 19 TESTING
Lab Director REBECCA SUN

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