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39D2267315 CLIA NUMBER - 2209 MACDADE LLC

Laboratory Demographics

CLIA Number: 39D2267315

Facility Name: 2209 MACDADE LLC

Facility Address:
2209 MACDADE BLVD
HOLMES, PA
ZIP 19043
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Facility Phone Number: 610 461-4123

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1093234171

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 39D2267315
LAB Type Pharmacy
Facility Name 2209 MACDADE LLC
Street 2209 MACDADE BLVD
City HOLMES
State PA
ZIP 19043
Phone 610 461-4123
CertificateType 4
CertificateEffectiveDate 8/23/2022
CertificateExpirationDate 8/22/2024
FacilityType Waiver

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