31D2292907 CLIA NUMBER - BROAD ST PHARMACY LLC

Laboratory Demographics

  • CLIA Code: 31D2292907
  • Facility Name: BROAD ST PHARMACY LLC
  • Facility Address: 1285 BROAD ST, STE 3
    BLOOMFIELD, NJ
    ZIP 07003
  • Facility Phone: 973 893-5957
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SHEREEN BADER
  • NPI Number: 1477231280
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 31D2292907
LAB Type Pharmacy
Facility Name BROAD ST PHARMACY LLC
Street 1285 BROAD ST, STE 3
City BLOOMFIELD
State NJ
ZIP 07003
Phone 973 893-5957
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/1/2023
Certificate Expiration Date 10/31/2025
Facility Type Pharmacy
Lab Director SHEREEN BADER

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