31D2282266 CLIA NUMBER - NEW JERSEY CVS PHARMACY, LLC DBA CVS/PHARMACY #00243

Laboratory Demographics

  • CLIA Code: 31D2282266
  • Facility Name: NEW JERSEY CVS PHARMACY, LLC DBA CVS/PHARMACY #00243
  • Facility Address: 4362 ROUTE 130 NORTH
    WILLINGBORO, NJ
    ZIP 08046
  • Facility Phone: 609 386-9411
  • Facility Type: Other - PHARMACIST
  • Facility Type: Waiver
  • Lab Director: YOUSEF KOTB
  • NPI Number: 1619069192
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 31D2282266
LAB Type Other - PHARMACIST
Facility Name NEW JERSEY CVS PHARMACY, LLC DBA CVS/PHARMACY #00243
Street 4362 ROUTE 130 NORTH
City WILLINGBORO
State NJ
ZIP 08046
Phone 609 386-9411
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/18/2025
Certificate Expiration Date 5/17/2027
Facility Type Other - PHARMACIST
Lab Director YOUSEF KOTB

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