31D2212562 CLIA NUMBER - BROADWAY HEALTH PHARMACY

Laboratory Demographics

CLIA Number: 31D2212562

Facility Name: BROADWAY HEALTH PHARMACY

Facility Address:
974 BROADWAY
BAYONNE, NJ
ZIP 07002
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Facility Phone Number: 201 471-2400

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1275061178

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	31D2212562
LAB Type	Pharmacy
Facility Name	BROADWAY HEALTH PHARMACY
Street	974 BROADWAY
City	BAYONNE
State	NJ
ZIP	07002
Phone	201 471-2400
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