10D2088945 CLIA NUMBER - PUBLIX PHARMACY #0027

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Laboratory Demographics

CLIA Number: 10D2088945

Facility Name: PUBLIX PHARMACY #0027

Facility Address:
13900 CR 455
CLERMONT, FL
ZIP 34711
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Facility Phone Number: 407 877-1565

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1134168008

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	10D2088945
LAB Type	Pharmacy
Facility Name	PUBLIX PHARMACY #0027
Street	13900 CR 455
City	CLERMONT
State	FL
ZIP	34711
Phone	407 877-1565
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