37D2224409 CLIA NUMBER - CVS/PHARMACY #10491 OKLAHOMA CVS PHARMACY, LLC

Laboratory Demographics

CLIA Number: 37D2224409

Facility Name: CVS/PHARMACY #10491 OKLAHOMA CVS PHARMACY, LLC

Facility Address:
3711 E FRANK PHILLIPS BLVD
BARTLESVILLE, OK
ZIP 74006
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Facility Phone Number: 401 765-1500

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1235541483

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	37D2224409
LAB Type	Pharmacy
Facility Name	CVS/PHARMACY #10491 OKLAHOMA CVS PHARMACY, LLC
Street	3711 E FRANK PHILLIPS BLVD
City	BARTLESVILLE
State	OK
ZIP	74006
Phone	401 765-1500
CertificateType	4
CertificateEffectiveDate	5/13/2023
CertificateExpirationDate	5/12/2025
FacilityType	Waiver

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