31D2287593 CLIA NUMBER - WALGREENS 19703

Laboratory Demographics

  • CLIA Code: 31D2287593
  • Facility Name: WALGREENS 19703
  • Facility Address: 33 RIVER ROAD
    BOGOTA, NJ
    ZIP 07603
  • Facility Phone: 201 489-7805
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PRANAVI MANDAVA
  • NPI Number: 1831613504
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 31D2287593
LAB Type Pharmacy
Facility Name WALGREENS 19703
Street 33 RIVER ROAD
City BOGOTA
State NJ
ZIP 07603
Phone 201 489-7805
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/15/2025
Certificate Expiration Date 8/14/2027
Facility Type Pharmacy
Lab Director PRANAVI MANDAVA

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