39D2238028 CLIA NUMBER - POCONO COMMUNITY PHARMACY II

Laboratory Demographics

CLIA Number: 39D2238028

Facility Name: POCONO COMMUNITY PHARMACY II

Facility Address:
175 E BROWN STREET, SUITE 107
EAST STROUDSBURG, PA
ZIP 18301
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Facility Phone Number: 570 664-8226

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1316417355

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	39D2238028
LAB Type	Pharmacy
Facility Name	POCONO COMMUNITY PHARMACY II
Street	175 E BROWN STREET, SUITE 107
City	EAST STROUDSBURG
State	PA
ZIP	18301
Phone	570 664-8226
CertificateType	4
CertificateEffectiveDate	9/30/2023
CertificateExpirationDate	9/29/2025
FacilityType	Waiver

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