10D2088963 CLIA NUMBER - PUBLIX PHARMACY #0507

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Laboratory Demographics

CLIA Number: 10D2088963

Facility Name: PUBLIX PHARMACY #0507

Facility Address:
1950 N HIGHWAY 19
EUSTIS, FL
ZIP 32726
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Facility Phone Number: 352 357-5885

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1073553459

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	10D2088963
LAB Type	Pharmacy
Facility Name	PUBLIX PHARMACY #0507
Street	1950 N HIGHWAY 19
City	EUSTIS
State	FL
ZIP	32726
Phone	352 357-5885
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