18D2000236 CLIA NUMBER - KROGER PHARMACY L-408

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Laboratory Demographics

CLIA Number: 18D2000236

Facility Name: KROGER PHARMACY L-408

Facility Address:
102 WEST JOHN ROWAN BLVD
BARDSTOWN, KY
ZIP 40004
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Facility Phone Number: 502 348-3062

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1265466080

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	18D2000236
LAB Type	Pharmacy
Facility Name	KROGER PHARMACY L-408
Street	102 WEST JOHN ROWAN BLVD
City	BARDSTOWN
State	KY
ZIP	40004
Phone	502 348-3062
CertificateType	4
CertificateEffectiveDate	11/24/2023
CertificateExpirationDate	11/23/2025
FacilityType	Waiver

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