31D2199078 CLIA NUMBER - WALGREENS # 17797

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Laboratory Demographics

CLIA Number: 31D2199078

Facility Name: WALGREENS # 17797

Facility Address:
432 BERGEN ST
HARRISON, NJ
ZIP 07029
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Facility Phone Number: 973 483-5336

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1790203735

Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

CLIA Record

Field Name	Field Value
CLIA Number	31D2199078
LAB Type	Pharmacy
Facility Name	WALGREENS # 17797
Street	432 BERGEN ST
City	HARRISON
State	NJ
ZIP	07029
Phone	973 483-5336
CertificateType	4
CertificateEffectiveDate	11/5/2022
CertificateExpirationDate	11/4/2024
FacilityType	Waiver

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