10D2088358 CLIA NUMBER - PUBLIX PHARMACY #0627

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Laboratory Demographics

CLIA Number: 10D2088358

Facility Name: PUBLIX PHARMACY #0627

Facility Address:
12139 W LINEBAUGH AVE
TAMPA, FL
ZIP 33626
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Facility Phone Number: 813 814-0738

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1801837307

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	10D2088358
LAB Type	Pharmacy
Facility Name	PUBLIX PHARMACY #0627
Street	12139 W LINEBAUGH AVE
City	TAMPA
State	FL
ZIP	33626
Phone	813 814-0738
CertificateType	4
CertificateEffectiveDate	12/15/2022
CertificateExpirationDate	12/14/2024
FacilityType	Waiver

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