10D2088765 CLIA NUMBER - PUBLIX PHARMACY #0641

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Laboratory Demographics

CLIA Number: 10D2088765

Facility Name: PUBLIX PHARMACY #0641

Facility Address:
5240 WEST STATE ROAD 46
SANFORD, FL
ZIP 32771
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Facility Phone Number: 407 688-2971

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1598704363

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	10D2088765
LAB Type	Pharmacy
Facility Name	PUBLIX PHARMACY #0641
Street	5240 WEST STATE ROAD 46
City	SANFORD
State	FL
ZIP	32771
Phone	407 688-2971
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