10D2186268 CLIA NUMBER - PUBLIC SQUARE PHARMACY LLC

Laboratory Demographics

  • CLIA Code: 10D2186268
  • Facility Name: PUBLIC SQUARE PHARMACY LLC
  • Facility Address: 11797 BEACH BLVD - STE 7
    JACKSONVILLE, FL
    ZIP 32246
  • Facility Phone: 904 531-4556
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DIEGO F. GOMEZ
  • NPI Number: 1992273023
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2186268
LAB Type Pharmacy
Facility Name PUBLIC SQUARE PHARMACY LLC
Street 11797 BEACH BLVD - STE 7
City JACKSONVILLE
State FL
ZIP 32246
Phone 904 531-4556
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/16/2024
Certificate Expiration Date 6/15/2026
Facility Type Pharmacy
Lab Director DIEGO F. GOMEZ

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