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10D2088530 CLIA NUMBER - PUBLIX PHARMACY #1280

Laboratory Demographics

CLIA Number: 10D2088530

Facility Name: PUBLIX PHARMACY #1280

Facility Address:
7950 DANI DR STE 200
FORT MYERS, FL
ZIP 33966
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Facility Phone Number: 239 936-3969

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1841523669

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name Field Value
CLIA Number 10D2088530
LAB Type Pharmacy
Facility Name PUBLIX PHARMACY #1280
Street 7950 DANI DR STE 200
City FORT MYERS
State FL
ZIP 33966
Phone 239 936-3969
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