10D2213068 CLIA NUMBER - FAMILY PHARMACY LLC

Laboratory Demographics

CLIA Number: 10D2213068

Facility Name: FAMILY PHARMACY LLC

Facility Address:
1436 STATE ROAD 436 SUITE 1008
CASSELBERRY, FL
ZIP 32707
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Facility Phone Number: 407 853-4010

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1881249548

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	10D2213068
LAB Type	Pharmacy
Facility Name	FAMILY PHARMACY LLC
Street	1436 STATE ROAD 436 SUITE 1008
City	CASSELBERRY
State	FL
ZIP	32707
Phone	407 853-4010
CertificateType	4
CertificateEffectiveDate	2/9/2023
CertificateExpirationDate	2/8/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024