01D2086977 CLIA NUMBER - PUBLIX PHARMACY #1086

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Laboratory Demographics

CLIA Number: 01D2086977

Facility Name: PUBLIX PHARMACY #1086

Facility Address:
5408 SUMMERVILLE ROAD STE 200
PHENIX CITY, AL
ZIP 36867
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Facility Phone Number: 334 291-8533

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1225077191

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	01D2086977
LAB Type	Pharmacy
Facility Name	PUBLIX PHARMACY #1086
Street	5408 SUMMERVILLE ROAD STE 200
City	PHENIX CITY
State	AL
ZIP	36867
Phone	334 291-8533
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