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31D2290123 CLIA NUMBER - WALGREENS 19690

Laboratory Demographics

CLIA Number: 31D2290123

Facility Name: WALGREENS 19690

Facility Address:
12 NORTH ST
BAYONNE, NJ
ZIP 07002
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Facility Phone Number: 201 436-6268

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1184148884

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

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
CertificateType 4
CertificateEffectiveDate 9/21/2023
CertificateExpirationDate 9/20/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024