10D2088852 CLIA NUMBER - PUBLIX PHARMACY #0748

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Laboratory Demographics

CLIA Number: 10D2088852

Facility Name: PUBLIX PHARMACY #0748

Facility Address:
1140 SW 36TH AVE
POMPANO BEACH, FL
ZIP 33069
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Facility Phone Number: 954 917-1737

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1205275757

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	10D2088852
LAB Type	Pharmacy
Facility Name	PUBLIX PHARMACY #0748
Street	1140 SW 36TH AVE
City	POMPANO BEACH
State	FL
ZIP	33069
Phone	954 917-1737
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