18D1107696 CLIA NUMBER - KROGER PHARMACY L-346

Laboratory Demographics

CLIA Number: 18D1107696

Facility Name: KROGER PHARMACY L-346

Facility Address:
3039 BRECKENRIDGE LANE
LOUISVILLE, KY
ZIP 40220
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Facility Phone Number: 502 454-6138

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1821022641

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	18D1107696
LAB Type	Pharmacy
Facility Name	KROGER PHARMACY L-346
Street	3039 BRECKENRIDGE LANE
City	LOUISVILLE
State	KY
ZIP	40220
Phone	502 454-6138
CertificateType	4
CertificateEffectiveDate	11/12/2023
CertificateExpirationDate	11/11/2025
FacilityType	Waiver

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