10D2106802 CLIA NUMBER - PUBLIX PHARMACY #1502

Laboratory Demographics

  • CLIA Code: 10D2106802
  • Facility Name: PUBLIX PHARMACY #1502
  • Facility Address: 2625 SIMPSON RD
    KISSIMMEE, FL
    ZIP 34744
  • Facility Phone: 407 348-7686
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KIMBERLY BONE
  • NPI Number: 1972543353
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2106802
LAB Type Pharmacy
Facility Name PUBLIX PHARMACY #1502
Street 2625 SIMPSON RD
City KISSIMMEE
State FL
ZIP 34744
Phone 407 348-7686
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/29/2023
Certificate Expiration Date 12/28/2025
Facility Type Pharmacy
Lab Director KIMBERLY BONE

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