10D2088689 CLIA NUMBER - PUBLIX PHARMACY #1011

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Laboratory Demographics

CLIA Number: 10D2088689

Facility Name: PUBLIX PHARMACY #1011

Facility Address:
2886 ALT US 19
PALM HARBOR, FL
ZIP 34683
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Facility Phone Number: 727 781-7204

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1518280312

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	10D2088689
LAB Type	Pharmacy
Facility Name	PUBLIX PHARMACY #1011
Street	2886 ALT US 19
City	PALM HARBOR
State	FL
ZIP	34683
Phone	727 781-7204
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