34D2118213 CLIA NUMBER - PUBLIX PHARMACY #1519

Laboratory Demographics

  • CLIA Code: 34D2118213
  • Facility Name: PUBLIX PHARMACY #1519
  • Facility Address: 631 BRAWLEY SCHOOL ROAD
    MOORESVILLE, NC
    ZIP 28117
  • Facility Phone: 863 668-1188
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MS. ALLISON BASSETT
  • NPI Number: 1366890964
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2118213
LAB Type Pharmacy
Facility Name PUBLIX PHARMACY #1519
Street 631 BRAWLEY SCHOOL ROAD
City MOORESVILLE
State NC
ZIP 28117
Phone 863 668-1188
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Pharmacy
Lab Director MS. ALLISON BASSETT

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This page was last updated on: 9/29/2025