10D2089067 CLIA NUMBER - PUBLIX PHARMACY #1328

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Laboratory Demographics

CLIA Number: 10D2089067

Facility Name: PUBLIX PHARMACY #1328

Facility Address:
1735 N E PINE ISLAND RD
CAPE CORAL, FL
ZIP 33909
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Facility Phone Number: 239 573-6493

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1336394451

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	10D2089067
LAB Type	Pharmacy
Facility Name	PUBLIX PHARMACY #1328
Street	1735 N E PINE ISLAND RD
City	CAPE CORAL
State	FL
ZIP	33909
Phone	239 573-6493
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