10D2117259 CLIA NUMBER - PUBLIX PHARMACY #1538

Laboratory Demographics

  • CLIA Code: 10D2117259
  • Facility Name: PUBLIX PHARMACY #1538
  • Facility Address: 15625 SOUTHERN BLVD
    LOXAHATCHEE, FL
    ZIP 33470
  • Facility Phone: 561 795-5551
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JON PYBUS
  • NPI Number: 1447603766
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2117259
LAB Type Pharmacy
Facility Name PUBLIX PHARMACY #1538
Street 15625 SOUTHERN BLVD
City LOXAHATCHEE
State FL
ZIP 33470
Phone 561 795-5551
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/12/2024
Certificate Expiration Date 8/11/2026
Facility Type Pharmacy
Lab Director JON PYBUS

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