42D2090621 CLIA NUMBER - PUBLIX PHARMACY #0360

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Laboratory Demographics

CLIA Number: 42D2090621

Facility Name: PUBLIX PHARMACY #0360

Facility Address:
1611 EAST GREENVILLE STREET
ANDERSON, SC
ZIP 29621
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Facility Phone Number: 864 231-5246

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1215978705

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	42D2090621
LAB Type	Pharmacy
Facility Name	PUBLIX PHARMACY #0360
Street	1611 EAST GREENVILLE STREET
City	ANDERSON
State	SC
ZIP	29621
Phone	864 231-5246
CertificateType	4
CertificateEffectiveDate	1/27/2023
CertificateExpirationDate	1/26/2025
FacilityType	Waiver

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