34D2089186 CLIA NUMBER - PUBLIX PHARMACY #1484

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Laboratory Demographics

CLIA Number: 34D2089186

Facility Name: PUBLIX PHARMACY #1484

Facility Address:
3110 FINCHER FARM ROAD
MATTHEWS, NC
ZIP 28105
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Facility Phone Number: 704 814-6018

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1033535570

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	34D2089186
LAB Type	Pharmacy
Facility Name	PUBLIX PHARMACY #1484
Street	3110 FINCHER FARM ROAD
City	MATTHEWS
State	NC
ZIP	28105
Phone	704 814-6018
CertificateType	4
CertificateEffectiveDate	12/22/2022
CertificateExpirationDate	12/21/2024
FacilityType	Waiver

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