10D2088502 CLIA NUMBER - PUBLIX PHARMACY #0715

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Laboratory Demographics

CLIA Number: 10D2088502

Facility Name: PUBLIX PHARMACY #0715

Facility Address:
3102 GRIFFIN ROAD
DANIA, FL
ZIP 33312
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Facility Phone Number: 954 961-1757

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1952340721

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	10D2088502
LAB Type	Pharmacy
Facility Name	PUBLIX PHARMACY #0715
Street	3102 GRIFFIN ROAD
City	DANIA
State	FL
ZIP	33312
Phone	954 961-1757
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