39D2222857 CLIA NUMBER - CVS/PHARMACY #00919

Laboratory Demographics

CLIA Number: 39D2222857

Facility Name: CVS/PHARMACY #00919

Facility Address:
2622 JENKINTOWN ROAD
GLENSIDE, PA
ZIP 19038
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Facility Phone Number: 401 770-6431

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1689778425

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	39D2222857
LAB Type	Pharmacy
Facility Name	CVS/PHARMACY #00919
Street	2622 JENKINTOWN ROAD
City	GLENSIDE
State	PA
ZIP	19038
Phone	401 770-6431
CertificateType	4
CertificateEffectiveDate	5/1/2023
CertificateExpirationDate	4/30/2025
FacilityType	Waiver

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