01D2086985 CLIA NUMBER - PUBLIX PHARMACY #1377

Laboratory Demographics

  • CLIA Code: 01D2086985
  • Facility Name: PUBLIX PHARMACY #1377
  • Facility Address: 4650 WEST MAIN STREET SUITE 700
    DOTHAN, AL
    ZIP 36305
  • Facility Phone: 334 792-6824
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. ALLISON M. BASSETT
  • NPI Number: 1477001352
  • Taxonomy: 183500000X - Pharmacist

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CLIA Record

Field Name Field Value
CLIA Number 01D2086985
LAB Type Pharmacy
Facility Name PUBLIX PHARMACY #1377
Street 4650 WEST MAIN STREET SUITE 700
City DOTHAN
State AL
ZIP 36305
Phone 334 792-6824
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/14/2024
Certificate Expiration Date 11/13/2026
Facility Type Pharmacy
Lab Director DR. ALLISON M. BASSETT

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This page was last updated on: 9/29/2025