10D2089000 CLIA NUMBER - PUBLIX PHARMACY #1132

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Laboratory Demographics

CLIA Number: 10D2089000

Facility Name: PUBLIX PHARMACY #1132

Facility Address:
19390 CORTEZ BLVD
BROOKSVILLE, FL
ZIP 34601
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Facility Phone Number: 352 796-2928

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1215025663

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	10D2089000
LAB Type	Pharmacy
Facility Name	PUBLIX PHARMACY #1132
Street	19390 CORTEZ BLVD
City	BROOKSVILLE
State	FL
ZIP	34601
Phone	352 796-2928
CertificateType	4
CertificateEffectiveDate	12/18/2022
CertificateExpirationDate	12/17/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024