31D2205314 CLIA NUMBER - WALGREENS# 04109

Laboratory Demographics

  • CLIA Code: 31D2205314
  • Facility Name: WALGREENS# 04109
  • Facility Address: 22 E SAINT GEORGES AVE
    LINDEN, NJ
    ZIP 07036
  • Facility Phone: 908 925-8570
  • Facility Type: Other - COVID 19 TEST SITE
  • Facility Type: Waiver
  • Lab Director: TONI M. PARK
  • NPI Number: 1639184625
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 31D2205314
LAB Type Other - COVID 19 TEST SITE
Facility Name WALGREENS# 04109
Street 22 E SAINT GEORGES AVE
City LINDEN
State NJ
ZIP 07036
Phone 908 925-8570
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/14/2024
Certificate Expiration Date 12/13/2026
Facility Type Other - COVID 19 TEST SITE
Lab Director TONI M. PARK

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