31D2290123 CLIA NUMBER - WALGREENS 19690

Laboratory Demographics

  • CLIA Code: 31D2290123
  • Facility Name: WALGREENS 19690
  • Facility Address: 12 NORTH ST
    BAYONNE, NJ
    ZIP 07002
  • Facility Phone: 201 436-6268
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARIAN H. BESHAE
  • NPI Number: 1184148884
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 31D2290123
LAB Type Pharmacy
Facility Name WALGREENS 19690
Street 12 NORTH ST
City BAYONNE
State NJ
ZIP 07002
Phone 201 436-6268
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/21/2025
Certificate Expiration Date 9/20/2027
Facility Type Pharmacy
Lab Director MARIAN H. BESHAE

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