31D2204985 CLIA NUMBER - BOP RX INC DBA BLACK OAK PHARMACY

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Laboratory Demographics

CLIA Number: 31D2204985

Facility Name: BOP RX INC DBA BLACK OAK PHARMACY

Facility Address:
879 BLACK OAK RIDGE ROAD
WAYNE, NJ
ZIP 07470
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Facility Phone Number: 973 837-8770

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1790295616

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	31D2204985
LAB Type	Pharmacy
Facility Name	BOP RX INC DBA BLACK OAK PHARMACY
Street	879 BLACK OAK RIDGE ROAD
City	WAYNE
State	NJ
ZIP	07470
Phone	973 837-8770
CertificateType	4
CertificateEffectiveDate	12/11/2022
CertificateExpirationDate	12/10/2024
FacilityType	Waiver

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