31D2220940 CLIA NUMBER - NEW JERSEY CVS PHARMACY, LLC DBA CVS/PHARMACY #02130

Laboratory Demographics

  • CLIA Code: 31D2220940
  • Facility Name: NEW JERSEY CVS PHARMACY, LLC DBA CVS/PHARMACY #02130
  • Facility Address: 198 NEW HAMPSHIRE AVENUE
    LAKEWOOD, NJ
    ZIP 08701
  • Facility Phone: 401 770-6431
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: WAHID BASKALY
  • NPI Number: 1295133833
  • Taxonomy: 207LP2900X - Anesthesiology

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CLIA Record

Field Name Field Value
CLIA Number 31D2220940
LAB Type Pharmacy
Facility Name NEW JERSEY CVS PHARMACY, LLC DBA CVS/PHARMACY #02130
Street 198 NEW HAMPSHIRE AVENUE
City LAKEWOOD
State NJ
ZIP 08701
Phone 401 770-6431
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/16/2025
Certificate Expiration Date 4/15/2027
Facility Type Pharmacy
Lab Director WAHID BASKALY

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This page was last updated on: 3/20/2025