10D2088481 CLIA NUMBER - PUBLIX PHARMACY #0854

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Laboratory Demographics

CLIA Number: 10D2088481

Facility Name: PUBLIX PHARMACY #0854

Facility Address:
2420 SANTA BARBARA BLVD
CAPE CORAL, FL
ZIP 33914
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Facility Phone Number: 239 768-1413

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1215977699

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	10D2088481
LAB Type	Pharmacy
Facility Name	PUBLIX PHARMACY #0854
Street	2420 SANTA BARBARA BLVD
City	CAPE CORAL
State	FL
ZIP	33914
Phone	239 768-1413
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