11D2093024 CLIA NUMBER - PUBLIX PHARMACY #0456

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Laboratory Demographics

CLIA Number: 11D2093024

Facility Name: PUBLIX PHARMACY #0456

Facility Address:
155 JONNY MERCER BLVD
SAVANNAH, GA
ZIP 31410
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Facility Phone Number: 863 688-1188

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1790724755

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	11D2093024
LAB Type	Pharmacy
Facility Name	PUBLIX PHARMACY #0456
Street	155 JONNY MERCER BLVD
City	SAVANNAH
State	GA
ZIP	31410
Phone	863 688-1188
CertificateType	4
CertificateEffectiveDate	3/18/2023
CertificateExpirationDate	3/17/2025
FacilityType	Waiver

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