18D2000244 CLIA NUMBER - KROGER PHARMACY L-712

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Laboratory Demographics

CLIA Number: 18D2000244

Facility Name: KROGER PHARMACY L-712

Facility Address:
810 INDIAN MOUND DR
MOUNT STERLING, KY
ZIP 40353
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Facility Phone Number: 859 497-9696

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1346274180

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	18D2000244
LAB Type	Pharmacy
Facility Name	KROGER PHARMACY L-712
Street	810 INDIAN MOUND DR
City	MOUNT STERLING
State	KY
ZIP	40353
Phone	859 497-9696
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