31D2286017 CLIA NUMBER - BERGEN ROAD PHARMACY

Laboratory Demographics

CLIA Number: 31D2286017

Facility Name: BERGEN ROAD PHARMACY

Facility Address:
239 OLD BERGEN ROAD
JERSEY CITY, NJ
ZIP 07305
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Facility Phone Number: 201 434-8062

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1134829773

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	31D2286017
LAB Type	Pharmacy
Facility Name	BERGEN ROAD PHARMACY
Street	239 OLD BERGEN ROAD
City	JERSEY CITY
State	NJ
ZIP	07305
Phone	201 434-8062
CertificateType	4
CertificateEffectiveDate	7/21/2023
CertificateExpirationDate	7/20/2025
FacilityType	Waiver

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