10D2088927 CLIA NUMBER - PUBLIX PHARMACY #1343

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Laboratory Demographics

CLIA Number: 10D2088927

Facility Name: PUBLIX PHARMACY #1343

Facility Address:
2180 W NINE MILE RD
PENSACOLA, FL
ZIP 32534
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Facility Phone Number: 850 473-5025

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1972757151

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	10D2088927
LAB Type	Pharmacy
Facility Name	PUBLIX PHARMACY #1343
Street	2180 W NINE MILE RD
City	PENSACOLA
State	FL
ZIP	32534
Phone	850 473-5025
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