10D2111504 CLIA NUMBER - PUBLIX PHARMACY #1513

Laboratory Demographics

  • CLIA Code: 10D2111504
  • Facility Name: PUBLIX PHARMACY #1513
  • Facility Address: 12500 SR 54
    ODESSA, FL
    ZIP 33556
  • Facility Phone: 727 376-9490
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KIMBERLY BONE
  • NPI Number: 1295193498
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2111504
LAB Type Pharmacy
Facility Name PUBLIX PHARMACY #1513
Street 12500 SR 54
City ODESSA
State FL
ZIP 33556
Phone 727 376-9490
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/8/2024
Certificate Expiration Date 4/7/2026
Facility Type Pharmacy
Lab Director KIMBERLY BONE

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