10D2088577 CLIA NUMBER - PUBLIX PHARMACY #1076

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Laboratory Demographics

CLIA Number: 10D2088577

Facility Name: PUBLIX PHARMACY #1076

Facility Address:
617 US HIGHWAY 17-92 WEST
HAINES CITY, FL
ZIP 33844
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Facility Phone Number: 863 419-1231

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1336189703

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	10D2088577
LAB Type	Pharmacy
Facility Name	PUBLIX PHARMACY #1076
Street	617 US HIGHWAY 17-92 WEST
City	HAINES CITY
State	FL
ZIP	33844
Phone	863 419-1231
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