10D2195626 CLIA NUMBER - PINE BROOK PHARMACY LLC

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Laboratory Demographics

CLIA Number: 10D2195626

Facility Name: PINE BROOK PHARMACY LLC

Facility Address:
14111 CORTEZ BLVD
BROOKSVILLE, FL
ZIP 34613
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Facility Phone Number: (352) 610-4347

Facility Type: PHARMACY

Certificate Type: Waiver

NPI Number: 1558596932

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	10D2195626
LAB Type	PHARMACY
Facility Name	PINE BROOK PHARMACY LLC
Street	14111 CORTEZ BLVD
City	BROOKSVILLE
State	FL
ZIP	34613
Phone	(352) 610-4347

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This page was last updated on: 5/11/2023