11D2095506 CLIA NUMBER - PUBLIX PHARMACY #0525

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Laboratory Demographics

CLIA Number: 11D2095506

Facility Name: PUBLIX PHARMACY #0525

Facility Address:
2816 WASHINGTON RD
AUGUSTA, GA
ZIP 30909
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Facility Phone Number: 706 731-5206

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1316987738

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	11D2095506
LAB Type	Pharmacy
Facility Name	PUBLIX PHARMACY #0525
Street	2816 WASHINGTON RD
City	AUGUSTA
State	GA
ZIP	30909
Phone	706 731-5206
CertificateType	4
CertificateEffectiveDate	5/7/2023
CertificateExpirationDate	5/6/2025
FacilityType	Waiver

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