10D2088908 CLIA NUMBER - PUBLIX PHARMACY #1296

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Laboratory Demographics

CLIA Number: 10D2088908

Facility Name: PUBLIX PHARMACY #1296

Facility Address:
13390 PERDIDO KEY DR
PENSACOLA, FL
ZIP 32507
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Facility Phone Number: 850 492-5095

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1871805440

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	10D2088908
LAB Type	Pharmacy
Facility Name	PUBLIX PHARMACY #1296
Street	13390 PERDIDO KEY DR
City	PENSACOLA
State	FL
ZIP	32507
Phone	850 492-5095
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