10D2088901 CLIA NUMBER - PUBLIX PHARMACY #1094

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Laboratory Demographics

CLIA Number: 10D2088901

Facility Name: PUBLIX PHARMACY #1094

Facility Address:
1415 E SUNRISE BLVD
FORT LAUDERDALE, FL
ZIP 33304
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Facility Phone Number: 954 888-8980

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1407896822

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	10D2088901
LAB Type	Pharmacy
Facility Name	PUBLIX PHARMACY #1094
Street	1415 E SUNRISE BLVD
City	FORT LAUDERDALE
State	FL
ZIP	33304
Phone	954 888-8980
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