31D2279000 CLIA NUMBER - WALGREENS HEALTH SERVICES, LLC

Laboratory Demographics

  • CLIA Code: 31D2279000
  • Facility Name: WALGREENS HEALTH SERVICES, LLC
  • Facility Address: 520 CONVERY SUITE 101
    PERTH AMBOY, NJ
    ZIP 08861
  • Facility Phone: 732 934-2159
  • Facility Type: Other - HEALTH CLINIC
  • Facility Type: Waiver
  • Lab Director: SASHIDARAN MOODLEY
  • NPI Number: 1669996526
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 31D2279000
LAB Type Other - HEALTH CLINIC
Facility Name WALGREENS HEALTH SERVICES, LLC
Street 520 CONVERY SUITE 101
City PERTH AMBOY
State NJ
ZIP 08861
Phone 732 934-2159
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/28/2025
Certificate Expiration Date 3/27/2027
Facility Type Other - HEALTH CLINIC
Lab Director SASHIDARAN MOODLEY

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