33D2191315 CLIA NUMBER - SUPER HEALTH PHARMACY LLC

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Laboratory Demographics

CLIA Number: 33D2191315

Facility Name: SUPER HEALTH PHARMACY LLC

Facility Address:
6390 AMBOY RD
STATEN ISLAND, NY
ZIP 10309
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Facility Phone Number: 718 967-4600

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1760836431

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	33D2191315
LAB Type	Pharmacy
Facility Name	SUPER HEALTH PHARMACY LLC
Street	6390 AMBOY RD
City	STATEN ISLAND
State	NY
ZIP	10309
Phone	718 967-4600
CertificateType	4
CertificateEffectiveDate	8/25/2020
CertificateExpirationDate	3/26/2027
FacilityType	Waiver

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