10D2088417 CLIA NUMBER - PUBLIX PHARMACY #1135

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Laboratory Demographics

CLIA Number: 10D2088417

Facility Name: PUBLIX PHARMACY #1135

Facility Address:
5642 FISHHAWK CROSSING BLVD
LITHIA, FL
ZIP 33547
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Facility Phone Number: 813 662-2037

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1861400640

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	10D2088417
LAB Type	Pharmacy
Facility Name	PUBLIX PHARMACY #1135
Street	5642 FISHHAWK CROSSING BLVD
City	LITHIA
State	FL
ZIP	33547
Phone	813 662-2037
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