11D2093059 CLIA NUMBER - PUBLIX PHARMACY #1186

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Laboratory Demographics

CLIA Number: 11D2093059

Facility Name: PUBLIX PHARMACY #1186

Facility Address:
11701 ABERCORN ST
SAVANNAH, GA
ZIP 31419
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Facility Phone Number: 912 925-4117

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1033387741

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	11D2093059
LAB Type	Pharmacy
Facility Name	PUBLIX PHARMACY #1186
Street	11701 ABERCORN ST
City	SAVANNAH
State	GA
ZIP	31419
Phone	912 925-4117
CertificateType	4
CertificateEffectiveDate	3/19/2023
CertificateExpirationDate	3/18/2025
FacilityType	Waiver

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