10D2116804 CLIA NUMBER - PUBLIX PHARMACY #1523

Laboratory Demographics

  • CLIA Code: 10D2116804
  • Facility Name: PUBLIX PHARMACY #1523
  • Facility Address: 11460 S US HWY 301
    RIVERVIEW, FL
    ZIP 33569
  • Facility Phone: 813 671-9557
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TANISHA WHITE
  • NPI Number: 1467491415
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2116804
LAB Type Pharmacy
Facility Name PUBLIX PHARMACY #1523
Street 11460 S US HWY 301
City RIVERVIEW
State FL
ZIP 33569
Phone 813 671-9557
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/2/2024
Certificate Expiration Date 8/1/2026
Facility Type Pharmacy
Lab Director TANISHA WHITE

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