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10D0958218 CLIA NUMBER - PUBLIX PHARMACY #1302

Laboratory Demographics

CLIA Number: 10D0958218

Facility Name: PUBLIX PHARMACY #1302

Facility Address:
13401 SUMMERLIN RD
FORT MYERS, FL
ZIP 33919
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Facility Phone Number: 239 481-3321

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1700826161

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 10D0958218
LAB Type Pharmacy
Facility Name PUBLIX PHARMACY #1302
Street 13401 SUMMERLIN RD
City FORT MYERS
State FL
ZIP 33919
Phone 239 481-3321
CertificateType 4
CertificateEffectiveDate 3/15/2023
CertificateExpirationDate 3/14/2025
FacilityType Waiver

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