10D2088870 CLIA NUMBER - PUBLIX PHARMACY #0179

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Laboratory Demographics

CLIA Number: 10D2088870

Facility Name: PUBLIX PHARMACY #0179

Facility Address:
11566 US HIGHWAY 1
PALM BEACH GARDENS, FL
ZIP 33408
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Facility Phone Number: 561 775-1027

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1700102092

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	10D2088870
LAB Type	Pharmacy
Facility Name	PUBLIX PHARMACY #0179
Street	11566 US HIGHWAY 1
City	PALM BEACH GARDENS
State	FL
ZIP	33408
Phone	561 775-1027
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