10D2088763 CLIA NUMBER - PUBLIX PHARMACY #0607

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Laboratory Demographics

CLIA Number: 10D2088763

Facility Name: PUBLIX PHARMACY #0607

Facility Address:
1921 SOUTH ALAFAYA TRAIL
ORLANDO, FL
ZIP 32828
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Facility Phone Number: 407 277-6608

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1730128604

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	10D2088763
LAB Type	Pharmacy
Facility Name	PUBLIX PHARMACY #0607
Street	1921 SOUTH ALAFAYA TRAIL
City	ORLANDO
State	FL
ZIP	32828
Phone	407 277-6608
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