31D2204027 CLIA NUMBER - PARK AVE PHARMACY

Laboratory Demographics

  • CLIA Code: 31D2204027
  • Facility Name: PARK AVE PHARMACY
  • Facility Address: 107 PARK AVE
    PATERSON, NJ
    ZIP 07501
  • Facility Phone: 973 928-8888
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARWAN K. ALRUBAEE
  • NPI Number: 1497052245
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 31D2204027
LAB Type Pharmacy
Facility Name PARK AVE PHARMACY
Street 107 PARK AVE
City PATERSON
State NJ
ZIP 07501
Phone 973 928-8888
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/7/2024
Certificate Expiration Date 12/6/2026
Facility Type Pharmacy
Lab Director MARWAN K. ALRUBAEE

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