37D2207466 CLIA NUMBER - BOULEVARD PHARMACY

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Laboratory Demographics

CLIA Number: 37D2207466

Facility Name: BOULEVARD PHARMACY

Facility Address:
117 SE FRANK PHILLIPS BLVD
BARTLESVILLE, OK
ZIP 74003
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Facility Phone Number: 918 336-2140

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1477638567

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	37D2207466
LAB Type	Pharmacy
Facility Name	BOULEVARD PHARMACY
Street	117 SE FRANK PHILLIPS BLVD
City	BARTLESVILLE
State	OK
ZIP	74003
Phone	918 336-2140
CertificateType	4
CertificateEffectiveDate	12/29/2022
CertificateExpirationDate	12/28/2024
FacilityType	Waiver

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