31D2219296 CLIA NUMBER - NEW JERSEY CVS PHARMACY, LLC DBA CVS/PHARMACY #06035

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Laboratory Demographics

CLIA Number: 31D2219296

Facility Name: NEW JERSEY CVS PHARMACY, LLC DBA CVS/PHARMACY #06035

Facility Address:
1099 ROUTE 33 HAMILTON SQUARE
HAMILTON, NJ
ZIP 08690
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Facility Phone Number: 401 770-6431

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1073993242

Taxonomy: 320900000X - Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.

CLIA Record

Field Name	Field Value
CLIA Number	31D2219296
LAB Type	Pharmacy
Facility Name	NEW JERSEY CVS PHARMACY, LLC DBA CVS/PHARMACY #06035
Street	1099 ROUTE 33 HAMILTON SQUARE
City	HAMILTON
State	NJ
ZIP	08690
Phone	401 770-6431
CertificateType	4
CertificateEffectiveDate	4/5/2023
CertificateExpirationDate	4/4/2025
FacilityType	Waiver

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