10D2088717 CLIA NUMBER - PUBLIX PHARMACY #0062

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Laboratory Demographics

CLIA Number: 10D2088717

Facility Name: PUBLIX PHARMACY #0062

Facility Address:
1160 STATE ROAD 434
WINTER SPRINGS, FL
ZIP 32708
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Facility Phone Number: 407 327-9731

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1982645487

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	10D2088717
LAB Type	Pharmacy
Facility Name	PUBLIX PHARMACY #0062
Street	1160 STATE ROAD 434
City	WINTER SPRINGS
State	FL
ZIP	32708
Phone	407 327-9731
CertificateType	4
CertificateEffectiveDate	12/17/2022
CertificateExpirationDate	12/16/2024
FacilityType	Waiver

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