01D2086956 CLIA NUMBER - PUBLIX PHARMACY #1203

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Laboratory Demographics

CLIA Number: 01D2086956

Facility Name: PUBLIX PHARMACY #1203

Facility Address:
22031 US HIGHWAY 72
ATHENS, AL
ZIP 35613
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Facility Phone Number: 256 230-2324

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1477705432

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	01D2086956
LAB Type	Pharmacy
Facility Name	PUBLIX PHARMACY #1203
Street	22031 US HIGHWAY 72
City	ATHENS
State	AL
ZIP	35613
Phone	256 230-2324
CertificateType	4
CertificateEffectiveDate	11/14/2022
CertificateExpirationDate	11/13/2024
FacilityType	Waiver

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