10D2089064 CLIA NUMBER - PUBLIX PHARMACY #1326

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Laboratory Demographics

CLIA Number: 10D2089064

Facility Name: PUBLIX PHARMACY #1326

Facility Address:
4651 CORTEZ RD WEST
BRADENTON, FL
ZIP 34210
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Facility Phone Number: 941 792-7325

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1104154822

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	10D2089064
LAB Type	Pharmacy
Facility Name	PUBLIX PHARMACY #1326
Street	4651 CORTEZ RD WEST
City	BRADENTON
State	FL
ZIP	34210
Phone	941 792-7325
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