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42D1092674 CLIA NUMBER - PUBLIX PHARMACY #0874

Laboratory Demographics

CLIA Number: 42D1092674

Facility Name: PUBLIX PHARMACY #0874

Facility Address:
215 PELHAM RD
GREENVILLE, SC
ZIP 29615
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Facility Phone Number: 864 370-8215

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1376583716

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 42D1092674
LAB Type Pharmacy
Facility Name PUBLIX PHARMACY #0874
Street 215 PELHAM RD
City GREENVILLE
State SC
ZIP 29615
Phone 864 370-8215
CertificateType 4
CertificateEffectiveDate 3/16/2023
CertificateExpirationDate 3/15/2025
FacilityType Waiver

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