10D2088487 CLIA NUMBER - PUBLIX PHARMACY #0528

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Laboratory Demographics

CLIA Number: 10D2088487

Facility Name: PUBLIX PHARMACY #0528

Facility Address:
18341 PINE BLVD
PEMBROKE PINES, FL
ZIP 33029
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Facility Phone Number: 954 430-6106

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1821039322

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	10D2088487
LAB Type	Pharmacy
Facility Name	PUBLIX PHARMACY #0528
Street	18341 PINE BLVD
City	PEMBROKE PINES
State	FL
ZIP	33029
Phone	954 430-6106
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