10D2088558 CLIA NUMBER - PUBLIX PHARMACY #0684

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Laboratory Demographics

CLIA Number: 10D2088558

Facility Name: PUBLIX PHARMACY #0684

Facility Address:
17445 US HIGHWAY 192 STE 11
CLERMONT, FL
ZIP 34714
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Facility Phone Number: 352 243-0785

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1972542827

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	10D2088558
LAB Type	Pharmacy
Facility Name	PUBLIX PHARMACY #0684
Street	17445 US HIGHWAY 192 STE 11
City	CLERMONT
State	FL
ZIP	34714
Phone	352 243-0785
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