31D2241462 CLIA NUMBER - MADURA RX LLC DBA MADURA PHARMACY

Laboratory Demographics

  • CLIA Code: 31D2241462
  • Facility Name: MADURA RX LLC DBA MADURA PHARMACY
  • Facility Address: 115 N BROADWAY
    SOUTH AMBOY, NJ
    ZIP 08879
  • Facility Phone: 732 721-1732
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SUDHIR PATEL
  • NPI Number: 1861867038
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 31D2241462
LAB Type Pharmacy
Facility Name MADURA RX LLC DBA MADURA PHARMACY
Street 115 N BROADWAY
City SOUTH AMBOY
State NJ
ZIP 08879
Phone 732 721-1732
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/28/2023
Certificate Expiration Date 10/27/2025
Facility Type Pharmacy
Lab Director SUDHIR PATEL

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