10D2088894 CLIA NUMBER - PUBLIX PHARMACY #0567

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Laboratory Demographics

CLIA Number: 10D2088894

Facility Name: PUBLIX PHARMACY #0567

Facility Address:
2517 SOUTH FEDERAL HIGHWAY
FORT PIERCE, FL
ZIP 34982
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Facility Phone Number: 772 467-2188

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1932149366

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	10D2088894
LAB Type	Pharmacy
Facility Name	PUBLIX PHARMACY #0567
Street	2517 SOUTH FEDERAL HIGHWAY
City	FORT PIERCE
State	FL
ZIP	34982
Phone	772 467-2188
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