01D2090087 CLIA NUMBER - PUBLIX PHARMACY #1206

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Laboratory Demographics

CLIA Number: 01D2090087

Facility Name: PUBLIX PHARMACY #1206

Facility Address:
655 FIELDSTOWN RD
GARDENDALE, AL
ZIP 35071
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Facility Phone Number: 205 608-4682

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1407252992

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	01D2090087
LAB Type	Pharmacy
Facility Name	PUBLIX PHARMACY #1206
Street	655 FIELDSTOWN RD
City	GARDENDALE
State	AL
ZIP	35071
Phone	205 608-4682
CertificateType	4
CertificateEffectiveDate	1/14/2023
CertificateExpirationDate	1/13/2025
FacilityType	Waiver

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