10D2109597 CLIA NUMBER - PUBLIX PHARMACY #1492

Laboratory Demographics

  • CLIA Code: 10D2109597
  • Facility Name: PUBLIX PHARMACY #1492
  • Facility Address: 7550 NW 104TH AVE
    MIAMI, FL
    ZIP 33178
  • Facility Phone: 305 418-9756
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KIMBERLY BONE
  • NPI Number: 1679944953
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2109597
LAB Type Pharmacy
Facility Name PUBLIX PHARMACY #1492
Street 7550 NW 104TH AVE
City MIAMI
State FL
ZIP 33178
Phone 305 418-9756
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/29/2024
Certificate Expiration Date 2/27/2026
Facility Type Pharmacy
Lab Director KIMBERLY BONE

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