31D2225906 CLIA NUMBER - WALGREENS #15557

Laboratory Demographics

  • CLIA Code: 31D2225906
  • Facility Name: WALGREENS #15557
  • Facility Address: 395 BROAD STREET
    RED BANK, NJ
    ZIP 07701
  • Facility Phone: 732 945-1505
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: GENA G. IBRAHIM
  • NPI Number: 1487037727
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 31D2225906
LAB Type Pharmacy
Facility Name WALGREENS #15557
Street 395 BROAD STREET
City RED BANK
State NJ
ZIP 07701
Phone 732 945-1505
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/25/2025
Certificate Expiration Date 5/24/2027
Facility Type Pharmacy
Lab Director GENA G. IBRAHIM

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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