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33D2250574 CLIA NUMBER - HENDRIX PHARMACY

Laboratory Demographics

CLIA Number: 33D2250574

Facility Name: HENDRIX PHARMACY

Facility Address:
209 BROAD STREET
STATEN ISLAND, NY
ZIP 10304
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Facility Phone Number: 718 524-8988

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1386316909

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 33D2250574
LAB Type Pharmacy
Facility Name HENDRIX PHARMACY
Street 209 BROAD STREET
City STATEN ISLAND
State NY
ZIP 10304
Phone 718 524-8988
CertificateType 4
CertificateEffectiveDate 1/27/2022
CertificateExpirationDate 3/26/2027
FacilityType Waiver

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