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10D2234455 CLIA NUMBER - BROADWAY DISCOUNT PHARMACY

Laboratory Demographics

CLIA Number: 10D2234455

Facility Name: BROADWAY DISCOUNT PHARMACY

Facility Address:
1765 N BROADWAY AVE
BARTOW, FL
ZIP 33830
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Facility Phone Number: 863 537-7656

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1215439609

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name Field Value
CLIA Number 10D2234455
LAB Type Pharmacy
Facility Name BROADWAY DISCOUNT PHARMACY
Street 1765 N BROADWAY AVE
City BARTOW
State FL
ZIP 33830
Phone 863 537-7656
CertificateType 4
CertificateEffectiveDate 8/31/2023
CertificateExpirationDate 8/30/2025
FacilityType Waiver

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