42D2095960 CLIA NUMBER - PUBLIX PHARMACY #1478

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Laboratory Demographics

CLIA Number: 42D2095960

Facility Name: PUBLIX PHARMACY #1478

Facility Address:
10225 OCEAN HWY 17
PAWLEYS ISLAND, SC
ZIP 29585
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Facility Phone Number: 843 235-3775

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1922499912

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	42D2095960
LAB Type	Pharmacy
Facility Name	PUBLIX PHARMACY #1478
Street	10225 OCEAN HWY 17
City	PAWLEYS ISLAND
State	SC
ZIP	29585
Phone	843 235-3775
CertificateType	4
CertificateEffectiveDate	5/13/2023
CertificateExpirationDate	5/12/2025
FacilityType	Waiver

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