31D2287209 CLIA NUMBER - WALGREENS 17847

Laboratory Demographics

  • CLIA Code: 31D2287209
  • Facility Name: WALGREENS 17847
  • Facility Address: 1212 SUMMIT AVE
    JERSEY CITY, NJ
    ZIP 07307
  • Facility Phone: 201 876-0107
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AVILA HUMBERTO
  • NPI Number: 1770007601
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 31D2287209
LAB Type Pharmacy
Facility Name WALGREENS 17847
Street 1212 SUMMIT AVE
City JERSEY CITY
State NJ
ZIP 07307
Phone 201 876-0107
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/10/2025
Certificate Expiration Date 8/9/2027
Facility Type Pharmacy
Lab Director AVILA HUMBERTO

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