10D2115190 CLIA NUMBER - PUBLIX PHARMACY #1072

Laboratory Demographics

  • CLIA Code: 10D2115190
  • Facility Name: PUBLIX PHARMACY #1072
  • Facility Address: 155 E 2ND AVE
    HIALEAH, FL
    ZIP 33010
  • Facility Phone: 305 863-8616
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ERICA PHILLIPS
  • NPI Number: 1518337351
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2115190
LAB Type Pharmacy
Facility Name PUBLIX PHARMACY #1072
Street 155 E 2ND AVE
City HIALEAH
State FL
ZIP 33010
Phone 305 863-8616
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/30/2024
Certificate Expiration Date 6/29/2026
Facility Type Pharmacy
Lab Director ERICA PHILLIPS

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