15D1021823 CLIA NUMBER - KROGER LIMITED PARTNERSHIP

Laboratory Demographics

CLIA Number: 15D1021823

Facility Name: KROGER LIMITED PARTNERSHIP

Facility Address:
5960 CASTLEWAY W DR
INDIANAPOLIS, IN
ZIP 46250
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Facility Phone Number: 317 579-8434

Facility Type: Other

Certificate Type: Waiver

NPI Number: 1659576395

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	15D1021823
LAB Type	Other
Facility Name	KROGER LIMITED PARTNERSHIP
Street	5960 CASTLEWAY W DR
City	INDIANAPOLIS
State	IN
ZIP	46250
Phone	317 579-8434
CertificateType	4
CertificateEffectiveDate	2/2/2024
CertificateExpirationDate	2/1/2026
FacilityType	Waiver

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