10D1021181 CLIA NUMBER - PUBLIX PHARMACY #0713

Laboratory Demographics

  • CLIA Code: 10D1021181
  • Facility Name: PUBLIX PHARMACY #0713
  • Facility Address: 4765 HODGES BLVD
    JACKSONVILLE, FL
    ZIP 32224
  • Facility Phone: 904 223-5932
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALLISON BASSETT
  • NPI Number: 1093754046
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D1021181
LAB Type Pharmacy
Facility Name PUBLIX PHARMACY #0713
Street 4765 HODGES BLVD
City JACKSONVILLE
State FL
ZIP 32224
Phone 904 223-5932
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/19/2024
Certificate Expiration Date 8/18/2026
Facility Type Pharmacy
Lab Director ALLISON BASSETT

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