10D2088520 CLIA NUMBER - PUBLIX PHARMACY #1156

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Laboratory Demographics

CLIA Number: 10D2088520

Facility Name: PUBLIX PHARMACY #1156

Facility Address:
2160 MCGREGOR BLVD
FORT MYERS, FL
ZIP 33901
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Facility Phone Number: 239 332-4881

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1205021300

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	10D2088520
LAB Type	Pharmacy
Facility Name	PUBLIX PHARMACY #1156
Street	2160 MCGREGOR BLVD
City	FORT MYERS
State	FL
ZIP	33901
Phone	239 332-4881
CertificateType	4
CertificateEffectiveDate	12/16/2022
CertificateExpirationDate	12/15/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024