31D2211980 CLIA NUMBER - BLOOMING HEALTH LLC

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Laboratory Demographics

CLIA Number: 31D2211980

Facility Name: BLOOMING HEALTH LLC

Facility Address:
40 PARK AVE
PARK RIDGE, NJ
ZIP 07656
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Facility Phone Number: 201 554-2200

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1104596840

Taxonomy: 3336L0003X - Pharmacy
A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.

CLIA Record

Field Name	Field Value
CLIA Number	31D2211980
LAB Type	Pharmacy
Facility Name	BLOOMING HEALTH LLC
Street	40 PARK AVE
City	PARK RIDGE
State	NJ
ZIP	07656
Phone	201 554-2200
CertificateType	4
CertificateEffectiveDate	2/2/2023
CertificateExpirationDate	2/1/2025
FacilityType	Waiver

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