33D2186031 CLIA NUMBER - MEDFORD CHEMISTS INC

Laboratory Demographics

CLIA Number: 33D2186031

Facility Name: MEDFORD CHEMISTS INC

Facility Address:
2608 RTE 112
MEDFORD, NY
ZIP 11763
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Facility Phone Number: 631 475-4476

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1477586832

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	33D2186031
LAB Type	Pharmacy
Facility Name	MEDFORD CHEMISTS INC
Street	2608 RTE 112
City	MEDFORD
State	NY
ZIP	11763
Phone	631 475-4476
CertificateType	4
CertificateEffectiveDate	6/12/2020
CertificateExpirationDate	3/26/2027
FacilityType	Waiver

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