10D2088822 CLIA NUMBER - PUBLIX PHARMACY #0796

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Laboratory Demographics

CLIA Number: 10D2088822

Facility Name: PUBLIX PHARMACY #0796

Facility Address:
5655 RED BUG LAKE ROAD
WINTER SPRINGS, FL
ZIP 32708
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Facility Phone Number: 407 695-5814

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1346289212

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	10D2088822
LAB Type	Pharmacy
Facility Name	PUBLIX PHARMACY #0796
Street	5655 RED BUG LAKE ROAD
City	WINTER SPRINGS
State	FL
ZIP	32708
Phone	407 695-5814
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