10D2088450 CLIA NUMBER - PUBLIX PHARMACY #0012

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Laboratory Demographics

CLIA Number: 10D2088450

Facility Name: PUBLIX PHARMACY #0012

Facility Address:
600 N UNIVERSITY DR
PEMBROKE PINES, FL
ZIP 33024
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Facility Phone Number: 954 433-4408

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1447290887

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	10D2088450
LAB Type	Pharmacy
Facility Name	PUBLIX PHARMACY #0012
Street	600 N UNIVERSITY DR
City	PEMBROKE PINES
State	FL
ZIP	33024
Phone	954 433-4408
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