10D2104146 CLIA NUMBER - PUBLIX PHARMACY #1493

Laboratory Demographics

  • CLIA Code: 10D2104146
  • Facility Name: PUBLIX PHARMACY #1493
  • Facility Address: 250 PALM COAST PKWY E
    PALM COAST, FL
    ZIP 32137
  • Facility Phone: 386 597-4781
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CRAIG BRUBAKER
  • NPI Number: 1053780122
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2104146
LAB Type Pharmacy
Facility Name PUBLIX PHARMACY #1493
Street 250 PALM COAST PKWY E
City PALM COAST
State FL
ZIP 32137
Phone 386 597-4781
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/28/2023
Certificate Expiration Date 10/27/2025
Facility Type Pharmacy
Lab Director CRAIG BRUBAKER

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This page was last updated on: 9/29/2025