10D2088788 CLIA NUMBER - PUBLIX PHARMACY #0742

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Laboratory Demographics

CLIA Number: 10D2088788

Facility Name: PUBLIX PHARMACY #0742

Facility Address:
482 E ALTAMONTE DRIVE
ALTAMONTE SPRINGS, FL
ZIP 32701
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Facility Phone Number: 407 260-9985

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1235179649

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	10D2088788
LAB Type	Pharmacy
Facility Name	PUBLIX PHARMACY #0742
Street	482 E ALTAMONTE DRIVE
City	ALTAMONTE SPRINGS
State	FL
ZIP	32701
Phone	407 260-9985
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