31D2212334 CLIA NUMBER - VITALIS PHARMACY

Laboratory Demographics

CLIA Number: 31D2212334

Facility Name: VITALIS PHARMACY

Facility Address:
3495 JF KENNEDY BLVD
JERSEY CITY, NJ
ZIP 07307
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Facility Phone Number: 201 222-1800

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1851725964

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	31D2212334
LAB Type	Pharmacy
Facility Name	VITALIS PHARMACY
Street	3495 JF KENNEDY BLVD
City	JERSEY CITY
State	NJ
ZIP	07307
Phone	201 222-1800
CertificateType	4
CertificateEffectiveDate	2/4/2023
CertificateExpirationDate	2/3/2025
FacilityType	Waiver

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