31D2217554 CLIA NUMBER - NEW JERSEY CVS PHARMACY, LLC DBA CVS/PHARMACY # 00519

Laboratory Demographics

CLIA Number: 31D2217554

Facility Name: NEW JERSEY CVS PHARMACY, LLC DBA CVS/PHARMACY # 00519

Facility Address:
85 GODWIN AVE, MIDLAND PARK S/C
MIDLAND PARK, NJ
ZIP 07432
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Facility Phone Number: 401 770-6431

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1013009596

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	31D2217554
LAB Type	Pharmacy
Facility Name	NEW JERSEY CVS PHARMACY, LLC DBA CVS/PHARMACY # 00519
Street	85 GODWIN AVE, MIDLAND PARK S/C
City	MIDLAND PARK
State	NJ
ZIP	07432
Phone	401 770-6431
CertificateType	4
CertificateEffectiveDate	3/22/2023
CertificateExpirationDate	3/21/2025
FacilityType	Waiver

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